EULAR report on the use of ultrasonography in painful knee osteoarthritis. Part 1: Prevalence of inflammation in osteoarthritis

D'Agostino, Maria Antonietta; Conaghan, Philip G.; Bars, Manuela Le; Baron, Gabriel; Grassi, Walter; Martı́n-Mola, Emilio; Wakefield, Richard J.; Brasseur, J.-L.; Sô, A.; Backhaus, Marina; Malaise, Michel; Burmester, Gerd-RÃ1⁄4diger; Schmidely, N.; Ravaud, Philippe; Dougados, Maxime; Emery, Paul

doi:10.1136/ard.2005.037994

Cited by 231 publications

(210 citation statements)

References 21 publications

(19 reference statements)

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“…The demographics, clinical, and US evaluations have already been presented in detail. 16 Briefly, the 600 included subjects had a mean (SD) age of 66.7 (9.8), 165 (27.5%) were male, and the mean (SD) body mass index was 29.9 (5.3). When primary outcome definitions were used 322 (53.7%) had no US evidence of inflammation, 16 (2.7%) had synovitis alone, 177 (29.5%) had effusion alone, and 85 (14.2%) had both synovitis and effusion.…”

Section: Resultsmentioning

confidence: 99%

“…The previous report on the US findings of the present cohort 16 included a multivariate logistic regression model that demonstrated the variables associated with the highest probability of having US detected synovial inflammation, according to the primary outcome definitions. However, such probabilities are not generally useful for clinicians when faced with an individual patient.…”

Section: Discussionmentioning

confidence: 99%

“…Table 1 summarises the clinical and US evaluations recorded and the US technique is described in detail in the first report from this study. 16 The following US definitions were employed as the primary outcome:…”

Section: Methodsmentioning

confidence: 99%

“…15 We conducted a large cross sectional study using US to determine the presence of synovial inflammation in painful knee OA. 16 This project aimed at determining if clinical decision rules could be developed that would provide high levels of both sensitivity and specificity for detecting US synovial inflammation (synovial hypertrophy or effusion) for individual patients.…”

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confidence: 99%

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Eular Report on the Use of Ultrasonography in Painful Knee Osteoarthritis Part 2: Exploring Decision Rules for Clinical Utility

&NA;

2005

Ultrasound Quarterly

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Background: Synovial inflammation (as defined by hypertrophy and effusion) is common in osteoarthritis (OA) and may be important in both pain and structural progression. Objective: To determine if decision rules can be devised from clinical findings and ultrasonography (US) to allow recognition of synovial inflammation in patients with painful knee OA. Methods: A EULAR-ESCISIT cross sectional, multicentre study enrolled subjects with painful OA knee who had clinical, radiographic, and US evaluations. A classification and regression tree (CART) analysis was performed to find combinations of predictor variables that would provide high sensitivity and specificity for clinically detecting synovitis and effusion in individual subjects. A range of definitions for the two key US variables, synovitis and effusion (using different combinations of synovial thickness, depth, and appearance), were also included in exploratory analyses. Results: 600 patients with knee OA were included in the analysis. For both knee synovitis and joint effusion, the sensitivity and specificity were poor, yielding unsatisfactory likelihood ratios (75% sensitivity, 45% specificity, and positive LR of 1.36 for knee synovitis; 71.6% sensitivity, 43.2% specificity, and positive LR of 1.26 for joint effusion). The exploratory analyses did not improve the sensitivity and specificity (demonstrating positive LRs of between 1.26 and 1.57). Conclusion: Although it is possible to determine clinical and radiological predictors of OA inflammation in populations, CART analysis could not be used to devise useful clinical decision rules for an individual subject. Thus sensitive imaging techniques such as US remain the most useful tool for demonstrating synovial inflammation of the knee at the individual level.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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Eular Report on the Use of Ultrasonography in Painful Knee Osteoarthritis Part 2: Exploring Decision Rules for Clinical Utility

&NA;

2005

Ultrasound Quarterly

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“…Experimental knee pain models make it possible to test the isolated effects of pain on motor functions in healthy volunteers without the influence of confounding disease-related factors (24). It has recently been demonstrated that experimental knee joint pain significantly reduces knee muscle strength (25) as well as causing gait changes comparable to changes seen in knee OA (26).…”

Section: Introductionmentioning

confidence: 99%

Experimental knee joint pain during strength training and muscle strength gain in healthy subjects: A randomized controlled trial

Sørensen¹,

Langberg²,

Hodges³

et al. 2011

Arthritis Care & Research

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Objective. Knee joint pain and reduced quadriceps strength are cardinal symptoms in many knee pathologies. In people with painful knee pathologies, quadriceps exercise reduces pain, improves physical function, and increases muscle strength. A general assumption is that pain compromises muscle function and thus may prevent effective rehabilitation. This study evaluated the effects of experimental knee joint pain during quadriceps strength training on muscle strength gain in healthy individuals. Methods. Twenty-seven healthy untrained volunteers participated in a randomized controlled trial of quadriceps strengthening (3 times per week for 8 weeks). Participants were randomized to perform resistance training either during pain induced by injections of painful hypertonic saline (pain group, n ‫؍‬ 13) or during a nonpainful control condition with injection of isotonic saline (control group, n ‫؍‬ 14) into the infrapatellar fat pad. The primary outcome measure was change in maximal isokinetic muscle strength in knee extension/flexion (60, 120, and 180 degrees/second). Results. The group who exercised with pain had a significantly larger improvement in isokinetic muscle strength at all angular velocities of knee extension compared to the control group. In knee flexion there were improvements in isokinetic muscle strength in both groups with no between-group differences. Conclusion. Experimental knee joint pain improved the training-induced gain in muscle strength following 8 weeks of quadriceps training. It remains to be studied whether knee joint pain has a positive effect on strength gain in patients with knee pathology.

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New Drugs and Nutraceuticals in the Treatment of Osteoarthritis

Henrotin

Reginster

2011

Pharmaceutical Sciences Encyclopedia

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Osteoarthritis is a disease with a multifactorial etiology affecting all joint tissues and involving both biochemical and mechanical factors that act in synergy to degrade cartilage. Until now, OA treatments are limited to pain relief, even if some new drugs of the SYSADOA class have shown potential structure‐modifying effects. These drugs target cartilage as the endpoint of joint failure, underestimating the role played by subchondral bone and synovium in this process. However, recent studies emphasized the key role played by subchondral bone sclerosis and synovium inflammation in OA pathophysiology. Unfortunately, until now, there is no validated method for a reliable assessment of structural changes in these tissues, explaining that guidance documents edited by the official agencies and scientific societies are strictly focused on the assessment of cartilage changes.

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EULAR report on the use of ultrasonography in painful knee osteoarthritis. Part 1: Prevalence of inflammation in osteoarthritis

Cited by 231 publications

References 21 publications

Eular Report on the Use of Ultrasonography in Painful Knee Osteoarthritis Part 2: Exploring Decision Rules for Clinical Utility

Eular Report on the Use of Ultrasonography in Painful Knee Osteoarthritis Part 2: Exploring Decision Rules for Clinical Utility

Experimental knee joint pain during strength training and muscle strength gain in healthy subjects: A randomized controlled trial

New Drugs and Nutraceuticals in the Treatment of Osteoarthritis

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