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Rheumatology Advance Access published online on September 19, 2008
Rheumatology, doi:10.1093/rheumatology/ken339
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

How do pain and function vary with compartmental distribution and severity of radiographic knee osteoarthritis?

R. Duncan1, G. Peat1, E. Thomas1, L. Wood1, E. Hay1 and P. Croft1

1Arthritis Research Campaign National Primary Care Centre, Primary Care Sciences, Keele University, Keele, UK.

Correspondence to: R. Duncan, Arthritis Research Campaign National Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5BG, UK. E-mail: r.c.duncan{at}cphc.keele.ac.uk


  Abstract

Objectives. In radiographic OA (ROA) of the knee, how does radiographic severity and pattern of compartmental involvement influence symptoms?

Methods. Population-based study of 819 adults aged ≥50 yrs with knee pain. The severity of knee pain and function were measured using the Western Ontario and McMaster Universities scale. Three radiographic views of the knees were obtained.

Results. Seven hundred and seventy-seven participants were eligible (mean age 65.5 yrs, 357 males). Higher ROA severity in each of the tibiofemoral (TF) and patellofemoral (PF) compartments was independently associated with higher mean pain scores (TF: F2, 700 = 9.0, P < 0.0001, PF: F2, 700 = 12.7, P < 0.0001). The same pattern was found for mean function scores (TF: F2, 705 = 7.1, P = 0.001, PF: F2, 705 = 15.9, P < 0.0001). If either the TF or PF compartment was affected by moderate/severe OA, the added presence of OA in the other compartment did not increase the mean pain or function scores.

Conclusions. It is the severity of radiographic disease within a compartment, rather than the distribution of radiographic disease between compartments that is associated with symptoms. ROA in the PF joint is associated with symptoms, emphasizing the importance of radiographic changes in his joint.

KEY WORDS: Knee osteoarthritis, Pain, Function, Clinical Assessment Study of the Knee, Radiographic severity, Population study

Submitted 22 April 2008; revised version accepted 15 July 2008.
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