The discordance between clinical and radiographic knee osteoarthritis: A systematic search and summary of the literature

By J. Bedson, Peter Croft. BMC Musculoskeletal Disorders, 2008

942 citations recorded by the source corpus.

BackgroundStudies have suggested that the symptoms of knee osteoarthritis (OA) are rather weakly associated with radiographic findings and vice versa. Our objectives were to identify estimates of the prevalence of radiographic knee OA in adults with knee pain and of knee pain in adults with radiographic knee OA, and determine if the definitions of x ray osteoarthritis and symptoms, and variation in demographic factors influence these estimates.MethodsA systematic literature search identifying population studies which combined x rays, diagnosis, clinical signs and symptoms in knee OA. Estimates of the prevalence of radiographic OA in people with knee pain were determined and vice versa. In addition the effects of influencing factors were scrutinised.ResultsThe proportion of those with knee pain found to have radiographic osteoarthritis ranged from 15–76%, and in those with radiographic knee OA the proportion with pain ranged from 15% – 81%. Considerable variation occurred with x ray view, pain definition, OA grading and demographic factorsConclusionKnee pain is an imprecise marker of radiographic knee osteoarthritis but this depends on the extent of radiographic views used. Radiographic knee osteoarthritis is likewise an imprecise guide to the likelihood that knee pain or disability will be present. Both associations are affected by the definition of pain used and the nature of the study group. The results of knee x rays should not be used in isolation when assessing individual patients with knee pain.

Subfields: Rheumatology, Surgery

View Paper: https://www.semanticscholar.org/paper/5ef92313496548708e3d09389a557933e484f85c

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Rheumatology

1. A. Anderson
2. Richard F. Loeser
3. B. Heidari

In Surgery

1. A. Anderson
2. Richard F. Loeser
3. B. Heidari

Citations in the corpus

• Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I. (2011, positive): “OA and 15-81% of those with radiographic knee OA had pain (12).”
• Why is Osteoarthritis an Age-Related Disease? (2010, positive): “A recent systematic review [4] comparing the prevalence of knee pain and radiographic knee OA found considerable discordance between the two, adding further evidence that joint pain and severity of radiographic changes of OA do not correlate.”
• The Revised IASP definition of pain: concepts, challenges, and compromises (2020, background): “An illustrative example is the discordance between reports of pain and the structural abnormalities visualized by imaging in patients with knee osteoarthritis.(6,30,36) The IASP has defined nociplastic pain as “pain that arises from altered nociception despite no clear evidence of actual or threaten”