Structural correlates of pain in joints with osteoarthritis

Hunter, David J.; Guermazi, Ali; Roemer, Frank W.; Zhang, Yuqing; Neogi, Tuhina

doi:10.1016/j.joca.2013.05.017

Cited by 162 publications

(157 citation statements)

References 71 publications

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“…Only the anterior extrusion of the medial meniscus was associated with medial pain after adjustment for other MRI findings. Osteophytes represent in fact new bone formation at the joint margins and periostitis can be associated with this process [34], possibly generating and explaining the intensity of the pain.…”

Section: Inter-observer Agreementmentioning

confidence: 99%

Pain in bilateral knee osteoarthritis – correlations between clinical examination, radiological, and ultrasonographical findings.

et al. 2016

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Aims: The aim of the study was to evaluate the correlations between clinical symptoms (pain), physical examination, ultrasound (US), and radiological findings in patients with bilateral knee osteoarthritis (OA). Material and methods: Knee pain was appreciated during medial and lateral palpation of each knee joint and using visual analogue scale (VAS) and The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). US evaluation (osteophytes, meniscal protrusion, synovial fluid, femoral hyaline cartilage thickness) and radiological assessment (osteophytes, femoral-tibial space, Kellgren-Lawrence [K-L] score, enthesopathies) were performed by two examiners blinded to the clinical results and to each other. All these findings were scored with a five-point scale. Results: A total of 52 consecutive patients aged 63.44±9.49 were examined, 33 (80.5%) being females. In patients with bilateral knee OA the pain, evaluated by WOMAC score and VAS, was correlated with the presence of osteophytes and cartilage thickness but no association with medial meniscal protrusion and effusion was demonstrated. Pain produced by palpation of the knee was strongly associated with the presence of medial osteophytes. VAS and WOMAC scores increased with the severity of radiological and US findings. The presence of osteophytes and articular cartilage damage at US examination were strongly and positively correlated with radiological K-L score. US examiners agreement was good for osteophytes and moderate for meniscal protrusion, cartilage damage, and synovial fluid. The cartilage damage score was the only independent predictor for VAS scale; for WOMAC score the sex, cartilage damage, the presence of medial osteophytes and lateral meniscal protrusion were the independent predictors. Conclusion: Pain intensity was correlated with the severity of US findings, cartilage damage score being an independent predictor for both VAS and WOMAC scores. Medial osteophytes and lateral meniscal protrusion and are independent predictors for WOMAC score.

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Section: Inter-observer Agreementmentioning

confidence: 99%

Pain in bilateral knee osteoarthritis – correlations between clinical examination, radiological, and ultrasonographical findings.

et al. 2016

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“…The total annual cost of OA per patient has been estimated to be as much as $5,700 in the US 5. Pain and impaired joint function are the main limiting symptoms affecting patients with OA, which typically develops over the course of many years, with varying symptom intensity over time 6. The modern management of symptomatic hip or knee OA involves holistic assessment and selection of therapies from a wide range of options, ranging from lifestyle interventions and education to oral medication and joint replacement surgery 7.…”

Section: Introductionmentioning

confidence: 99%

Defining an International Standard Set of Outcome Measures for Patients With Hip or Knee Osteoarthritis: Consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group

Rolfson

Wissig²,

Maasakkers³

et al. 2016

Arthritis Care & Research

120

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ObjectiveTo define a minimum Standard Set of outcome measures and case‐mix factors for monitoring, comparing, and improving health care for patients with clinically diagnosed hip or knee osteoarthritis (OA), with a focus on defining the outcomes that matter most to patients.MethodsAn international working group of patients, arthroplasty register experts, orthopedic surgeons, primary care physicians, rheumatologists, and physiotherapists representing 10 countries was assembled to review existing literature and practices for assessing outcomes of pharmacologic and nonpharmacologic OA therapies, including surgery. A series of 8 teleconferences, incorporating a modified Delphi process, were held to reach consensus.ResultsThe working group reached consensus on a concise set of outcome measures to evaluate patients’ joint pain, physical functioning, health‐related quality of life, work status, mortality, reoperations, readmissions, and overall satisfaction with treatment result. To support analysis of these outcome measures, pertinent baseline characteristics and risk factor metrics were defined. Annual outcome measurement is recommended for all patients.ConclusionWe have defined a Standard Set of outcome measures for monitoring the care of people with clinically diagnosed hip or knee OA that is appropriate for use across all treatment and care settings. We believe this Standard Set provides meaningful, comparable, and easy to interpret measures ready to implement in clinics and/or registries globally. We view this set as an initial step that, when combined with cost data, will facilitate value‐based health care improvements in the treatment of hip and knee OA.

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“…joint; the subchondral bone, periosteum, periarticular ligaments, periarticular muscle and joint capsule including its inner synovial lining are all richly innervated and are the likely source of nociception in OA. 98 The cartilage is in the "spotlight" in the field of OA; nonetheless, it is important to note that this disease of the whole joint concurrently affects other tissues that do contain nociceptors. A recent study suggested that areas of denuded cartilage are related to symptoms.…”

Section: Mrgfus Target and Applications In Musculoskeletal Pathologymentioning

confidence: 99%

MRI-guided focused ultrasound surgery in musculoskeletal diseases: the hot topics

Bazzocchi¹,

Napoli²,

Sacconi³

et al. 2016

BJR

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MRI-guided focused ultrasound surgery (MRgFUS) is a minimally invasive treatment guided by the most sophisticated imaging tool available in today's clinical practice. Both the imaging and therapeutic sides of the equipment are based on non-ionizing energy. This technique is a very promising option as potential treatment for several pathologies, including musculoskeletal (MSK) disorders. Apart from clinical applications, MRgFUS technology is the result of long, heavy and cumulative efforts exploring the effects of ultrasound on biological tissues and function, the generation of focused ultrasound and treatment monitoring by MRI. The aim of this article is to give an updated overview on a "new" interventional technique and on its applications for MSK and allied sciences

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Structural correlates of pain in joints with osteoarthritis

Abstract: We would envisage that over the next few years many of the pressing questions pertaining to research into the structure pain relationship will continue to be addressed. With this, we can expect clinically appropriate therapeutic advance.

Cited by 162 publications

References 71 publications

Pain in bilateral knee osteoarthritis – correlations between clinical examination, radiological, and ultrasonographical findings.

Pain in bilateral knee osteoarthritis – correlations between clinical examination, radiological, and ultrasonographical findings.

Defining an International Standard Set of Outcome Measures for Patients With Hip or Knee Osteoarthritis: Consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group

MRI-guided focused ultrasound surgery in musculoskeletal diseases: the hot topics

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