Clinical, Radiological and Ultrasonographic Findings Related to Knee Pain in Osteoarthritis (original) (raw)
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Clinical and ultrasonographic findings related to knee pain in osteoarthritis
Osteoarthritis and Cartilage, 2006
Objectives: To determine clinical and sonographic factors associated with painful episodes in patients with knee osteoarthritis (OA). Methods: In this cross-sectional controlled study, patients with primary knee OA (ACR criteria) were prospectively placed into two groups. Group A: 81 patients with knee pain during physical activity !30 mm in visual analogue scale (VAS) for pain for at least 48 h prior to inclusion; Group B: 20 patients without knee pain from at least 1 month prior to inclusion. Clinical parameters, knee radiographic and ultrasonographic findings were collected. The sonographic study assessed joint effusion in the suprapatellar pouch, infrapatellar superficial and deep bursitis, meniscal lesions, anserine tendinobursitis, and Baker's cyst. Results: Group A patients tended to be older and heavier women than group B (P < 0.05). The most frequent radiographic stage was III (57%) in group A, and I (35%) and II (35%) in group B, showing differences in the distribution of each radiographic stage (P < 0.005). The most frequent ultrasonographic finding in group A was suprapatellar effusion (79%), and in group B it was meniscal lesions (40%). Ultrasonographic findings showed in group A a significant increase of suprapatellar effusion (P < 0.001) and a tendency towards an increase of Baker's cyst (P ¼ 0.06). Suprapatellar effusion, Baker's cyst, and body mass index (BMI) were the factors associated with the appearance of pain after the logistic regression analysis. Conclusions: Suprapatellar effusion, Baker's cyst, and higher BMI are more frequent and seem to be risk factors of painful flare in OA of the knee.
Ultrasonographic features in symptomatic osteoarthritis of the knee and relation with pain
Rheumatology, 2014
Objective. Radiographic knee OA is moderately associated with pain. As OA is a disease of the entire joint, ultrasonography visualizing cartilage and soft tissue structures might provide more insight into the complex process of pain in knee OA. The objective of this study was to investigate the cross-sectional association between US findings and pain in knee OA.
Medical Ultrasonography, 2016
Aims: The aim of the study was to evaluate the correlations between clinical symptoms (pain), physical examination, ultrasound (US), and radiological findings in patients with bilateral knee osteoarthritis (OA). Material and methods: Knee pain was appreciated during medial and lateral palpation of each knee joint and using visual analogue scale (VAS) and The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC). US evaluation (osteophytes, meniscal protrusion, synovial fluid, femoral hyaline cartilage thickness) and radiological assessment (osteophytes, femoral-tibial space, Kellgren–Lawrence [K-L] score, enthesopathies) were performed by two examiners blinded to the clinical results and to each other. All these findings were scored with a five-point scale. Results: A total of 52 consecutive patients aged 63.44±9.49 were examined, 33 (80.5%) being females. In patients with bilateral knee OA the pain, evaluated by WOMAC score and VAS, was correlated with the presence ...
Are Joint Structure and Function Related to Medial Knee OA Pain? A Pilot Study
Clinical Orthopaedics and Related Research®, 2011
Background Although the severity of knee osteoarthritis (OA) usually is assessed using different measures of joint structure, function, and pain, the relationships between these measures are unclear. Purpose Therefore, we: (1) examined the relationships between the measures of knee structure (flexion-extension range of motion, radiographic tibiofemoral angle, and medial joint space), function (Knee Osteoarthritis Outcome Scores [KOOS], peak adduction angle, and moment), and pain (visual analog scale [VAS]); and (2) identified variables that best predicted knee pain.
Ultrasound findings in knee of patients of osteoarthritis and their correlation with pain
International Journal of Research in Orthopaedics, 2019
Background: Osteoarthritis (OA) is a common joint disorder, with the knee being one of the most frequently involved sites. Conventional radiography (CR), hitherto the primary imaging tool in OA, shows late and indirect findings. Ultrasound (US), on the other hand, offers the possibility to depict different structures within the knee. The main objectives of this study is to asses correlation of Ultrasonography (USG) findings of OA knees and pain assessed in each knee using a numerical rating scale (NRS) from 0 to 10.Methods: This study was a single center cross sectional observational study. Patients presenting to rheumatology clinic between February 2017 to March 2017 and satisfying ACR clinical criteria for osteoarthritis of knees were taken. Pain assessed in each knee using NRS. USG evaluation of painful knee was done using standard protocols.Results: In this study, 9 patients and 17 knees were examined. The mean age was 65.7 yrs with more females (66%) as compared to males (33.3%...
Physical Therapy and Rehabilitation
Background: Knee osteoarthritis (OA) commonly limits stair climbing. This study aimed to determine if self-reported pain and function and biomechanics during stair climbing were associated with ultrasound measured lower limb muscle thickness and isometric strength testing. Methods: Twenty-three patients with unilateral symptomatic knee OA were recruited from a musculoskeletal physiatry clinic. Patients answered the WOMAC questionnaire and Lower Extremity Activity Scale to assess subjective pain, stiffness, function, and daily physical activity. Patients thenperformed a stair climb test. Ultrasound measurements of the quadriceps, hip abductors, adductors, and ankle plantarflexors were obtained. Isometric muscle strength was assessed with a hand-held dynamometer. Data analysis utilized Pearson correlations. Results: Slower stair climb is associated with higher pain levels (r=0.75) and functional deficits (r=0.69). Ultrasound measured ankle plantarflexor thickness correlates with faster stair descent (r=0.64). Stair climb ascent speed is negatively correlated with muscle strength of the hip adductors (r=-0.55) and abductors (r=-0.55). Conclusions: Stair climb speed is associated with self-reported pain and function. Ankle plantarflexors, hip adductor and abductor muscles should be explored as clinical targets for knee OA therapy.
J Rheumatol, 2014
Objective. To determine the diagnostic test performance of location of pain and activity-related pain in identifying knees with patellofemoral joint (PFJ) structural damage. Methods. The Multicenter Osteoarthritis Study is a US National Institutes of Health-funded cohort study of older adults with or at risk of knee osteoarthritis. Subjects identified painful areas around the knee on a knee pain map and the Western Ontario and McMaster Universities Osteoarthritis Index was used to assess pain with stairs and walking on level ground. Cartilage damage and bone marrow lesions were assessed from knee magnetic resonance imaging. We determined the sensitivity, specificity, positive and negative predictive values for presence of anterior knee pain (AKP), pain with stairs, absence of pain while walking on level ground, and combinations of tests in discriminating knees with isolated PFJ structural damage from those with isolated tibiofemoral joint (TFJ) or no structural damage. Knees with mixed PFJ/TFJ damage were removed from our analyses because of the inability to determine which compartment was causing pain. Results. There were 407 knees that met our inclusion criteria. "Any" AKP had a sensitivity of 60% and specificity of 53%; and if AKP was the only area of pain, the sensitivity dropped to 27% but specificity rose to 81%. Absence of moderate pain with walking on level ground had the greatest sensitivity (93%) but poor specificity (13%). The combination of "isolated" AKP and moderate pain with stairs had poor sensitivity (9%) but the greatest specificity (97%) of strategies tested. Conclusion. Commonly used questions purported to identify knees with PFJ structural damage do not identify this condition with great accuracy.
Correlation of Pain, Physical Function and Radiography With Osteoarthritis of The knee
The incidence and prevalence may vary widely according to the type of epidemiologic studies, as well as by whether clinical or radiological definitions are used. At least 37% (and up to 68% in some studies) of persons 60 years and older have radiographic evidence of knee OA. 12.1% of adults aged 60 or older have symptomatic knee OA. In Bangladesh perspective prevalence of OAknee is 7.5% in rural area, 9.2% in urban slum, and 10.6% in urban affluent community. 2 The prevalence of osteoarthritis increases indefinitely with age,
BMJ, 2009
Objective To examine the relation of radiographic features of osteoarthritis to knee pain in people with knees discordant for knee pain in two cohorts. Design Within person, knee matched, case-control study. Setting and participants Participants in the Multicenter Osteoarthritis (MOST) and Framingham Osteoarthritis studies who had knee radiographs and assessments of knee pain. Main outcome measures Association of each pain measure (frequency, consistency, and severity) with radiographic osteoarthritis, as assessed by Kellgren and Lawrence grade (0-4) and osteophyte and joint space narrowing grades (0-3) among matched sets of two knees within individual participants whose knees were discordant for pain status. Results 696 people from MOST and 336 people from Framingham were included. Kellgren and Lawrence grades were strongly associated with frequent knee pain-for example, for Kellgren and Lawrence grade 4 v grade 0 the odds ratio for pain was 151 (95% confidence interval 43 to 526) in MOST and 73 (16 to 331) in Framingham (both P<0.001 for trend). Similar results were also seen for the relation of Kellgren and Lawrence scores to consistency and severity of knee pain. Joint space narrowing was more strongly associated with each pain measure than were osteophytes. Conclusions Using a method that minimises between person confounding, this study found that radiographic osteoarthritis and individual radiographic features of osteoarthritis were strongly associated with knee pain.