scholarly journals Relationships between Pain, Function and Radiographic Findings in Osteoarthritis of the Knee: A Cross-Sectional Study

Arthritis ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Duygu Cubukcu ◽  
Ayse Sarsan ◽  
Hakan Alkan

Objectives. The aim of this study was to investigate the relationships between pain, disability, and radiographic findings in patients with knee osteoarthritis (OA). Patients and Methods. A total of 114 patients with knee OA who attended the physical medicine and rehabilitation outpatient clinic were included in this study. The diagnosis was based on the American College of Rheumatology (ACR) criteria for knee OA. Age, duration of disease, and body mass index (BMI) of the patients were recorded. Radiographic features on the two-sided knee radiography were assessed with the Kellgren-Lawrence scale. The severity of knee pain, stiffness, and disability were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results. The mean age of the patients was 56.98 (±8.28) years and the mean disease duration was 4.14 (±4.15) years. Kellgren-Lawrence grading scale and age or disease duration were positively and significantly associated, whereas none of the WOMAC subscores were found to be related with Kellgren-Lawrence grading scale (). On the other hand, WOMAC disability scores were significantly associated with WOMAC pain and WOMAC stiffness (). Conclusions. Knee pain, stiffness, and duration of disease may affect the level of disability in the patients with knee OA. Therefore treatment of knee OA could be planned according to the clinical features and functional status instead of radiological findings.

2014 ◽  
Vol 94 (4) ◽  
pp. 490-498 ◽  
Author(s):  
Daniel L. Riddle ◽  
Paul W. Stratford

Background The presence of widespread pain is easily determined and is known to increase the risk for persistent symptoms. Objective The study hypothesis was that people with no or minimal knee osteoarthritis (OA) and high Western Ontario and McMaster Universities (WOMAC) Pain Scale scores would be more likely than other subgroups to report widespread pain. Design A cross-sectional design was used. Methods Data were obtained from the Multicenter Osteoarthritis Study, which includes people with or at high risk for knee OA. The inclusion criteria were met by 755 people with unilateral knee pain and 851 people with bilateral knee pain. Widespread pain was assessed with body diagrams, and radiographic Kellgren-Lawrence grades were recorded for each knee. Knee pain during daily tasks was quantified with WOMAC Pain Scale scores. Results Compared with people who had high levels of pain and knee OA, people with a low level of pain and a high level of knee OA, and people with low levels of pain and knee OA, a higher proportion of people with a high level of knee pain and a low level of knee OA had widespread pain. This result was particularly true for people with bilateral knee pain, for whom relative risk estimates ranged from 1.7 (95% confidence interval=1.2–2.4) to 2.3 (95% confidence interval=1.6–3.3). Limitations The cross-sectional design was a limitation. Conclusions People with either no or minimal knee OA and a high level of knee pain during daily tasks are particularly likely to report widespread pain. This subgroup is likely to be at risk for not responding to knee OA treatment that focuses only on physical impairments. Assessment of widespread pain along with knee pain intensity and OA status may assist physical therapists in identifying people who may require additional treatment.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 409.2-409
Author(s):  
E. Strebkova ◽  
E. Tchetina ◽  
L. Alekseeva

Background:Currently, a large number of molecular biological and genetic markers are known to be involved in the development of osteoarthritis (OA). The mammalian target of rapamycin (mTOR) signaling pathway is responsible for chondrocyte proliferation, cartilage matrix production, and cell growth. OA is characterized by increased mTOR synthesis, which is accompanied by an increase in proliferative activity and destruction of chondrocytes. Obesity is an important factor in the progression of knee OA. The study of mTOR expression in patients with OA and obesity is an urgent task in the development of personalized OA therapy.Objectives:To determine the expression of mTOR in patients with knee OA in combination with obesity and normal body weight. To evaluate the effect of mTOR on the clinical manifestations of OA in patients with different body mass index (BMI).Methods:The study included 73 female patients aged 45-65 y.o. with Kellgren-Lawrence stage II-III knee OA. The patients were divided into 2 groups: group 1 (n=50) with obesity (BMI > 30 kg / cm2) and group 2 (n=23) with normal or increased body weight (BMI < 30 kg/cm2). The average age of patients with obesity is 56.5 ± 5.87 years, without obesity - 58.7 ± 5.43 years. Clinical manifestations were evaluated by a WOMAС. RNA was isolated from the patients ‘ blood samples, which was used to determine the expression of mTOR.Results:Patients with knee OA with and without obesity did not differ in age. OA develops at an earlier age in obese patients, than in non-obese patients (p < 0.001). Patients from 1 group had a high BMI > 30 kg/m2 at the onset of OA. Obese patients had more severe knee OA is significantly more often detected: Kellgren-Lawrence stage III was determined in 10% of obese patients and in 4.35% - without obesity (p < 0.001). Significantly higher values of the WOMAC index pain, stiffness, joint functional failure, and total WOMAC were observed in obese patients (p = 0.006, p = 0.039, p = 0.037, and p = 0.014, respectively). Obese patients had higher VAS pain scores (p < 0.05) compared to patients with a lower BMI. Obese patients had a higher mTOR expression (p < 0.05) of 8.02±8.62, compared to non-obese patients. High mTOR expression was associated with VAS knee pain (r=0.78; p < 0.05) and WOMAC pain (r=0.89; p<0.05) in obese patients (Table 1).Table 1.Correlation of m-TORParametersmTOR (1 group, n=50)mTOR (2 group, n=23)Body weightр > 0,05р > 0,05Pain (VAS)r=0,78; р<0,05p = 0,07; r = 0,45Pain (WOMAC)r=0,89; р<0,05р > 0,05Total WOMACр > 0,05р > 0,05Conclusion:Our study showed that patients with obesity and knee OA have higher rates of mTOR expression, compared to patients with normal body weight. High mTOR expression correlates with the severity of knee pain in obese patients. Thus, the evaluation of mTOR expression in obese patients and knee OA plays an important role in predicting the severity of clinical manifestations of OA, and may influence the choice of personalized therapy tactics for such patients.Disclosure of Interests:None declared


2020 ◽  
Vol 100 (10) ◽  
pp. 1872-1881
Author(s):  
Daniel L Riddle ◽  
Robert A Perera

Abstract Objective The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) pain scale quantifies knee pain severity with activities of daily living, but the potential impact of pain in other body regions on WOMAC pain scores has not been explored using a causal modeling approach. The purpose of this study was to determine if pain in other areas of the body impact WOMAC pain scores, a phenomenon referred to as “crosstalk.” Methods Cross-sectional datasets were built from public use data available from the Osteoarthritis Initiative (OAI) and the Multicenter Osteoarthritis Study (MOST). The WOMAC Pain Scale and generic hip, knee, ankle, foot and back pain measures were included. Three nested regression models grounded in causally based classical test theory determined the extent of crosstalk. Improvements in the coefficient of determination across the 3 models were used to determine the presence of crosstalk. Results Causal modeling provided evidence of crosstalk in both OAI and MOST datasets. For example, in OAI, multiple statistical models demonstrated significant increases in coefficient of determination values (P &lt; .0001) as additional pain areas were added to the models. Conclusions Crosstalk appears to be a clinically important source of error in the WOMAC Pain Scale, particularly for patients with a larger number of painful body regions and when contralateral knee joint pain is more severe. Impact Statement This study has important implications for arthritis research. It also should raise clinician awareness of the threat to score interpretation and the need to consider the extent of pain in other body regions when interpreting WOMAC pain scores.


2015 ◽  
Vol 42 (12) ◽  
pp. 2398-2403 ◽  
Author(s):  
Daniel L. Riddle ◽  
Mateusz Makowski

Objective.Knee pain location is routinely assessed in clinical practice. We determined the patterns of patient-reported pain locations for persons with knee osteoarthritis (OA). We also examined associations between knee pain patterns and severity of self-reported pain with activity and self-reported functional status.Methods.The Osteoarthritis Initiative data were used to examine reports of pain location (localized, regional, or global) and type and extent of knee OA. Multivariable ANCOVA models were used to determine associations between the Knee Injury and Osteoarthritis Outcome Survey (KOOS) Pain and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Function scales and pain location after adjusting for potential confounding. We also used radar graphs to illustrate pain patterns for various locations and severity of knee OA.Results.Radar graphs of 2696 knees indicated that pain pattern and location and extent of knee OA demonstrate substantial overlap. An interaction between race and pain location was found for WOMAC Function, but not for KOOS Pain scores. Global knee pain was associated (p < 0.001) with substantially worse function (by 6.5 points in African Americans) compared with pain that was localized. Knee pain reported as global was independently associated (p < 0.001) with clinically important lower (worse by 3.9 points) KOOS Pain scores compared with pain that was localized.Conclusion.Pain patterns are not useful for inferring potential location or severity of knee OA in individual patients, but knee pain patterns that are global are independently associated with worse pain and function compared with localized pain, and associations differ for function based on race.


2020 ◽  
Vol 5 (3) ◽  
pp. 114-118
Author(s):  
Myat Sanda Kyaw ◽  
Hitoshi Tsuchihashi ◽  
Hideoki Ogawa ◽  
Shigaku Ikeda

Background: Although psoriasis is a Th1-dominant disease, certain investigations have also revealed the involvement of Th2 cells in the disease. Soluble CD30 (sCD30) is predominantly associated with various Th2 diseases. Therefore, the role of sCD30 in psoriasis requires further evaluation. Objectives: To evaluate the association between sCD30 and psoriasis. Methods: In this cross-sectional analytical study, the association between serum sCD30 levels and psoriasis was evaluated using enzyme-linked immunosorbent assay in sera obtained from patients with psoriasis. Results: The results indicated elevated sCD30 levels in 79 patients with psoriasis, and the levels were significantly higher in those with a prolonged duration of disease (duration > 10 years). Furthermore, there was a significant positive correlation between the duration of disease (years) and sCD30 (pg/mL) levels. These findings suggest that sCD30 is a useful marker for chronicity of psoriasis. Conclusion: Elevated sCD30 levels in psoriasis are associated with disease duration, and they may reflect the chronicity of psoriasis. Further research is required to determine the role of sCD30 in psoriasis.


Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Michael A Clynes ◽  
Faidra Laskou ◽  
Mark H Edwards ◽  
Cyrus Cooper ◽  
Angela Taylor ◽  
...  

Abstract Background Adolescent knee pain is a common complaint which may be due to patellar dislocation, meniscal tear, Osgood-Schlatter’s disease or patellofemoral maltracking. We studied the association of such pain with knee osteoarthritis (OA) 50 years later using a retrospective cohort design. Methods This study was based in the Hertfordshire Cohort Study, a cohort of men and women born in 1931 - 9. Participants completed a questionnaire detailing recall of adolescent knee pain, self-reported OA, demographics, lifestyle and The Western Ontario and McMaster Universities Arthritis Index (WOMAC). Clinical OA was defined based on the American College of Rheumatology (ACR) criteria and assessed at a clinical visit where knee radiographs were also taken and graded according to the methods of Kellgren and Lawrence. Results Completed data were available for 135 men and 139 women. The mean age was 78.8 (SD 2.6) years and the mean (SD) BMI was 26.3 (4.0). Two percent of men (n = 3) and 5% of women (n = 7) reported adolescent knee pain, of which 2 men and 3 women sought medical advice for their knee pain. 1 man and 2 women reported that their pain had been constant since teenage years while 2 men and 4 women reported that it was intermittent in nature. A report of adolescent knee pain was associated with an increased risk of clinical (odds ratio (OR) 5.45, p-value 0.015, 95% confidence interval (CI) 1.39 - 21.36); radiological (OR 2.33, p-value 0.228, 95% CI 0.60 - 9.24) and self-report (OR 2.71, p-value 0.134, 95% CI 0.74 - 10.0) of knee OA in later life. After adjustments for age, sex and BMI, adolescent knee pain was associated with an increased risk of clinical (OR 4.80, p-value 0.047, 95% CI 1.02 - 22.53); radiological (OR 1.85, p-value 0.404, 95% CI 0.44 - 7.78); self-report (OR 3.23, p-value 0.10, 95% CI 0.80 - 12.94) although relationships were only significant for clinical knee OA. Conclusion Recalled adolescent knee pain was associated with a clinical diagnosis of knee OA in later life. The lack of association with self-report of OA suggests that this is not simply a consequence of recall bias and exploration in other data sets is now indicated. Disclosures M.A. Clynes: None. F. Laskou: None. M.H. Edwards: None. C. Cooper: None. A. Taylor: None. M. Stokes: None. E.M. Dennison: None.


BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017652 ◽  
Author(s):  
Christelle Nguyen ◽  
Isabelle Boutron ◽  
Gabriel Baron ◽  
Emmanuel Coudeyre ◽  
Francis Berenbaum ◽  
...  

IntroductionOsteoarthritis (OA) pathophysiology is driven in part by joint inflammation. Resveratrol has in vitro anti-inflammatory properties. We aim to assess the efficacy of oral resveratrol for knee pain at 3 months in people with knee OA.Methods and analysisWe will conduct a randomised double-blind placebo-controlled trial. Overall, 164 individuals with knee OA fulfilling 1986 American College of Rheumatology criteria will be recruited in three tertiary care centres in France and randomised to receive oral resveratrol, 40 mg (two caplets) two times per day for 1 week, then 20 mg (one caplet) two times per day or a matching placebo for a total of 6 months. Randomisation will be centralised and stratified by centre. The allocation ratio of assignments will be 1:1. The primary outcome will be the mean change from baseline in knee pain on a self-administered 11-point pain Numeric Rating Scale at 3 months. Secondary outcomes will be the mean change in knee pain at 6 months, the function subscore of the Western Ontario and McMaster Universities Arthritis Index score, patient global assessment, proportion of responders according to the Osteoarthritis Research Society International–Outcome Measures in Rheumatology criteria at 3 and 6 months, and self-reported number of intra-articular injections of corticosteroids or hyaluronic acid and consumption of analgesics and non-steroidal anti-inflammatory drugs since the last contact. Other interventions will be allowed and self-reported. Adherence will be monitored by capsule counts and a booklet and adverse events recorded at 3 and 6 months. Statisticians, treating physicians and participants will be blinded to the allocated treatment.Ethics and disseminationThe oral resveratrol in knee osteoarthritis (ARTHROL) trial has been authorised by theAgenceNationale de Sécurité du Médicament et des Produits de Santéand ethics were approved by theComité deProtection des Personnes Île-de-FranceIII. The findings of the study will be published in a peer-reviewed journal and disseminated at conferences. The design of ARTHROL will warrant the translation of its findings into clinical practice.Trial registration numberClinicalTrials.gov identifier:NCT02905799. Pre-results. First received: 14 September 2016. Last updated: 16 September 2016. Status: not yet recruiting.


2021 ◽  
Vol 3 (1) ◽  
pp. 136-147
Author(s):  
Yuko Akagawa ◽  
Sachiko Makabe ◽  
Tomoko Ito ◽  
Yutaka Kimura ◽  
Hideaki Andoh

Parents who have cancer face particular problems in their relationships with children. This study aims to clarify 1) the current status of challenge/hope in parental cancer, 2) the factors related to challenge/hope, and 3) the relationship between challenge/hope and QOL/stress-coping ability. Cross-sectional national survey was conducted at designated cancer hospitals in Japan. Participants were undergoing cancer treatment and have children under 18 years old. The questionnaire included demographic data, QOL, ability to cope with stress, and challenge/hope. From 11 hospitals, 54 patients (response rate: 79.4%) participated. Majority of participants were female (72.2%) with the mean age of 39.3 ± 5.3 (SD). The total score was QOL (FACT-G: 50.4 ± 16.2), stress-coping ability (SOC: 46.7 ± 10.4). The main challenges were an inability to fulfill the parental role and children’s mental suffering due to loneliness. The main aspects of hope were the value of the children’s present self, being a parent, and strengthening family bonds. Gender and disease duration were significantly related with challenge/hope. Challenge was significantly related with QOL/stress-coping ability. Parents who have cancer derive hope from their relationship with their children, although they feel a gap between their ideal role/value as a parent and their current status.


2020 ◽  
Vol 100 (11) ◽  
pp. 1977-1986
Author(s):  
Aqeel M Alenazi ◽  
Mohammed M Alshehri ◽  
Shaima Alothman ◽  
Bader A Alqahtani ◽  
Jason Rucker ◽  
...  

Abstract Objective Osteoarthritis (OA) and diabetes mellitus (DM) often coexist and can result in negative outcomes. DM can affect pain and walking speed in people with knee OA; however, the impact of DM on OA is understudied. The purpose of this study was to investigate the association between diabetes and knee pain locations, pain severity while walking, and walking speed in people with knee OA. Methods A cross-sectional analysis was used. Data from 1790 individuals from the Osteoarthritis Initiative (mean [SD] age = 69 [8.7] years) with knee pain were included and grouped into knee OA and diabetes (n = 236) or knee OA only (n = 1554). Knee pain locations were categorized as no pain, localized pain, regional pain, or diffuse pain. Knee pain during a 20-m walk test was categorized as no pain, mild, moderate, or severe knee pain. Walking speed was measured using the 20-m walk test. Multinomial and linear regression analyses were performed. Results Diabetes was associated with regional knee pain (odds ratio [OR] = 1.77; 95% CI = 1.01–3.11). Diabetes was associated only with moderate (OR = 1.78; 95% CI = 1.02–3.10) or severe (OR = 2.52; 95% CI = 1.01–6.28) pain while walking. Diabetes was associated with decreased walking speed (B = −0.064; 95% CI = −0.09 to −0.03). Conclusions Diabetes was associated with regional knee pain but not with localized or diffuse knee pain and was associated with moderate to severe knee pain while walking and slower walking speed in people with knee OA. Impact Clinicians can use a knee pain map for examining knee pain locations for people with diabetes and knee OA. Knee pain during walking and walking speed should be screened for people with knee OA and diabetes because of the influence of diabetes on these parameters in this population. Lay Summary Diabetes might be associated with specific knee pain locations, pain during activities such as walking, and reduced walking speed in people with knee OA.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Hamide Ashraf ◽  
Alireza Salehi ◽  
Malihe Sousani ◽  
Mohammad Hossein Sharifi

Complementary Alternative Medicine (CAM) has been widely used in the world, but limited data are available on the use of CAM in depression. This study aimed to evaluate the use of CAM and its associated factors in depression. This cross-sectional study was conducted on 300 depressed patients referred to the Yasuj Neurology and Psychiatric Clinic, southern Iran, between 2019 and 2020. A valid semistructured international questionnaire was used; amongst the participants, 230 (77%) were female. The mean age of the patients was 41.47 ± 12.2 years and the mean duration of the disease was 4.49 ± 4.88 years. The prevalence of CAM use was 37.6% among the patients. The results showed a significant difference between the CAM users and nonusers regarding the disease duration ( p = 0.045 ) and body mass index ( p = 0.007 ). Moreover, the results of logistic regression analysis revealed a significant relationship between CAM use and female gender, disease duration, overweight, obesity, and self-employment ( p = 0.039 , p = 0.028 , p = 0.029 , p = 0.048 , and p = 0.044 , resp.). The most frequently used type of CAM was herbal medicine (97.35%) followed by pray therapy (23.89%). Additionally, the most widely used herbs were borage (77%), chamomile (46.9%), and lavender (21.2%). Furthermore, 62.8% of the patients reported that their main reason for using CAM was its effectiveness. The majority of the patients (77%) had not consulted their physicians prior to utilization of CAM therapies. Herbal medicine was the most common form of CAM in depression, with a high satisfaction level. Thus, it is necessary to increase physicians’ awareness in different fields of CAM.


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