Do clinical findings associate with radiographic osteoarthritis of the knee?

Claessens, Angela A. M. C.; Schouten, Jan S. A. G.; Ouweland, F. A. Van Den; Valkenburg, H. A.

doi:10.1136/ard.49.10.771

Cited by 117 publications

(81 citation statements)

References 6 publications

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“…Moreover, many studies have reported a high degree of discordance between clinical symptoms and radiographic findings of knee osteoarthritis [7][8][9]. In our study, patients with mild or minimal degenerative changes and severe symptoms were significantly relieved by embolization treatment.…”

Section: Discussionsupporting

confidence: 52%

Transcatheter Arterial Embolization as a Treatment for Medial Knee Pain in Patients with Mild to Moderate Osteoarthritis

Okuno

Korchi

Shinjo

et al. 2014

Cardiovasc Intervent Radiol

118

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Purpose Osteoarthritis is a common cause of pain and disability. Mild to moderate knee osteoarthritis that is resistant to nonsurgical options and not severe enough to warrant joint replacement represents a challenge in its management. On the basis of the hypothesis that neovessels and accompanying nerves are possible sources of pain, previous work demonstrated that transcatheter arterial embolization for chronic painful conditions resulted in excellent pain relief. We hypothesized that transcatheter arterial embolization can relieve pain associated with knee osteoarthritis. Methods Transcatheter arterial embolization for mild to moderate knee osteoarthritis using imipenem/cilastatin sodium or 75 lm calibrated Embozene microspheres as an embolic agent has been performed in 11 and three patients, respectively. We assessed adverse events and changes in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores. Results Abnormal neovessels were identified within soft tissue surrounding knee joint in all cases by arteriography. No major adverse events were related to the procedures. Transcatheter arterial embolization rapidly improved WOMAC pain scores from 12.2 ± 1.9 to 3.3 ± 2.1 at 1 month after the procedure, with further improvement at 4 months (1.7 ± 2.2) and WOMAC total scores from 47.3 ± 5.8 to 11.6 ± 5.4 at 1 month, and to 6.3 ± 6.0 at 4 months. These improvements were maintained in most cases at the final follow-up examination at a mean of 12 ± 5 months (range 4-19 months). Conclusion Transcatheter arterial embolization for mild to moderate knee osteoarthritis was feasible, rapidly relieved resistant pain, and restored knee function.

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Section: Discussionsupporting

confidence: 52%

Transcatheter Arterial Embolization as a Treatment for Medial Knee Pain in Patients with Mild to Moderate Osteoarthritis

Okuno

Korchi

Shinjo

et al. 2014

Cardiovasc Intervent Radiol

118

View full text Add to dashboard Cite

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“…A survey of the literature has shown disagreements between the results of clinical and radiological investigations. In general, however, these results are comparable to the results of this study, in which radiological scoring of the disease did not correlate with pain intensity or functional loss in the joint (28)(29)(30)(31). The reasons for these observations could have resulted from examination of only the tibiofemoral joint (30,31).…”

Section: Discussioncontrasting

confidence: 36%

“…In general, however, these results are comparable to the results of this study, in which radiological scoring of the disease did not correlate with pain intensity or functional loss in the joint (28)(29)(30)(31). The reasons for these observations could have resulted from examination of only the tibiofemoral joint (30,31). However, the results of investigation of both the tibiofemoral and the patellofemoral joints in the study presented here did not show a correlation between the Kellgren-Lawrence scores and the functional level or pain intensity.…”

Section: Discussioncontrasting

confidence: 36%

Associated Factors with Pain and Disability in Patients With Knee Osteoarthritis

et al. 2010

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ÖzetAmaç: Diz osteoartriti (OA) olan hastalarda ağrı ve fonksiyonel düzeyle ilişkili etkenleri belirlemektir. Yöntem ve Gereçler: Diz OA tanısı alan 161 hasta çalışmaya alın-dı. Hastaların yaş ortalaması 62.4± 8.7 yıl olup ortalama semptom süresi 43.76± 26.6 aydı. Hastaların yaş, cinsiyet, vücut kütle indeksi, eğitim düzeyi, sigara ve düzenli egzersiz alışkanlığı ve semptom süreleri kaydedildi. Ön-arka ve lateral diz grafilerinde Kellgren-Lawrence skorları hesaplandı. Hastaların fonksiyonel düzeyi Western Ontario ve McMaster Üniversitesi Osteoartrit İndeksi (WOMAC) ile, ağrı şiddeti Görsel Ağrı Skalası (GAS) ile değerlendirildi. Bulgular: Vücut kütle indeksi ile WOMAC ağrı skoru (r=0.592, p=0.0001), WOMAC eklem sertliği skoru (r=0.634, p=0.0001) ve WOMAC günlük yaşam aktiviteleri skoru (r=0.749, p=0.0001) arasında ilişki saptandı. Eğitim düzeyi ile WOMAC ağrı skoru (r=-0.394, p=0.001), WOMAC eklem sertliği skoru (r=-0.345, p=0.004), ve WOMAC günlük yaşam aktiviteleri skoru (r=-0.352, p=0.003) arasında ters ilişki saptandı. Kellgren-Lawrence skoru (ön-arka ve yan grafi) ile GAS skoru ve her üç WOMAC skoru arasında ilişki saptanmadı (p>0.05). Kellgren-Lawrence ön-arka ve yan grafi skorları yaş ve semptom süresiyle ilişkili bulundu (sırasıy-la r=0.263, p=0.001 ve r=0.339, p=0.016). GAS skoru ile herhangi bir parametre arasında ilişki saptanmadı. WOMAC alt grup skorları ve GAS skoru cinsiyete göre karşılaştırıldığında WOMAC ağrı skorunun bayanlarda daha yüksek olduğu saptandı (p= 0.024). Geri kalan faktörlerle WOMAC alt grup skorları arasında korelasyon saptanmadı. Sonuç: Vücut kütle indeksi, diz OA olan hastalarda fonksiyonel düzey ve ağrı şiddetiyle ilişkili en önemli faktördür. Hastalar, semptom ve hastalık şiddetini azaltmak açısından kilo vermeye teşvik edilmelidirler. (Turk J Rheumatol 2010; 25: 77-81 r=-0.394, r=-0.345, and r=-0.352, respectively). Kellgren-Lawrence scores of anteriorposterior and lateral view radiographs were found to be correlated with age and symptom duration (r=0,263, p=0,001 and r=0,339, p=0,016, respectively). No relationship was found between pain VAS scores and any assessed factors.When WOMAC subscale scores and VAS scores were compared according to gender, WOMAC pain scores were found higher in females (p=0.024). No correlation was found between remainder factors and scores of the three sections of WOMAC. Conclusion:The BMI is the most important factor associated with functional level and pain severity of patients with KOA. Patients must be encouraged to loose weight in order to decrease symptom and disease severity. (Turk J Rheumatol 2010; 25: 77-81)

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“…In the 2,800 patients with lumbar radiographs, they found a positive association between disc narrowing with chronic low back pain and disability. Interestingly, they found this moderate association between nearly as strong as the relationship between joint space narrowing and pain in knee osteoarthritis [8] and stronger than the association of radiographic hand osteoarthritis and pain [10]. In results from the Swedish Lumbar Spine Study, Hägg [18] showed that disc narrowing and personality characterized by low neuroticism were the only factors, which predicted improvement with fusion for low back pain.…”

Section: Discussionmentioning

confidence: 99%

The influence of preoperative MRI findings on lumbar fusion clinical outcomes

et al. 2012

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Introduction Spinal fusion as a treatment for degenerative disc disease is controversial. Prior authors have identified various MRI findings as being pain generators, which might help guide patient selection for lumbar fusion procedures. These findings have included disc desiccation, disc contour, high-intensity zone annular disruption, the presence of Modic endplate changes, and disc space collapse. The purpose of this study is to investigate which MRI findings in patients with degenerative disc disease predict clinical improvement with lumbar fusion. Methods A single-center surgical database of patients undergoing lumbar fusion was reviewed for patients whose indication for fusion surgery was primary disc pathology. We identified 51 patients (71 disc levels) who had completed 2-year prospectively collected outcomes questionnaires and had preoperative MRIs available for review. NRS (0-10) back and leg pain, Oswestry Disability Index (ODI) and SF-36 Physical Composite Summary scores were obtained preoperatively and at 1-and 2-year followup. MRIs were reviewed by three fellowship-trained spine surgeons who were asked to grade them for the following five characteristics: (a) disc desiccation, (b) disc contour, (c) presence of a high-intensity zone (HIZ) annular tear, (d) presence of Modic endplate changes and (e) disc height. Two-year outcome measures were compared to MRI findings to identify which findings correlated with improvement in outcome scores.Results Statistically significant improvements were noted in back pain, leg pain, SF-36 PCS and ODI in the group overall. Disc desiccation, disc contour, presence of an HIZ lesion, and the presence of Modic endplate changes did not correlate with 2-year outcomes. Disc height was correlated with 2-year change in outcome measures. Discs with preoperative height less than 5 mm demonstrated a 23.4 point ODI improvement compared to 9.2 points for discs [7 mm. Similarly, SF-36 PCS improved 9.5 points in discs \5 mm compared to 0.7 in discs greater than 7 mm. Discs between 5 and 7 mm demonstrated intermediate levels of improvement. Conclusions Several commonly utilized MRI criteria proposed as indications for lumbar fusion do not seem to correlate with 2-year improvement in clinical outcomes. Discs which are narrowed and collapsed, preoperatively, demonstrate better improvement at 2 years postoperatively as compared to discs which have maintained disc height. Significant disc space collapse may represent a subset of ''degenerative disc disease'' which responds more favorably to treatment with fusion.

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Do clinical findings associate with radiographic osteoarthritis of the knee?

Cited by 117 publications

References 6 publications

Transcatheter Arterial Embolization as a Treatment for Medial Knee Pain in Patients with Mild to Moderate Osteoarthritis

Transcatheter Arterial Embolization as a Treatment for Medial Knee Pain in Patients with Mild to Moderate Osteoarthritis

Associated Factors with Pain and Disability in Patients With Knee Osteoarthritis

The influence of preoperative MRI findings on lumbar fusion clinical outcomes

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