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Multicenter Study
. 2009 Aug 21:339:b2844.
doi: 10.1136/bmj.b2844.

Association between radiographic features of knee osteoarthritis and pain: results from two cohort studies

Tuhina Neogi  1 , David Felson, Jingbo Niu, Michael Nevitt, Cora E Lewis, Piran Aliabadi, Burt Sack, James Torner, Lawrence Bradley, Yuqing Zhang
Affiliations
Multicenter Study

Association between radiographic features of knee osteoarthritis and pain: results from two cohort studies

Tuhina Neogi et al. BMJ. .

Abstract

Objective: To examine the relation of radiographic features of osteoarthritis to knee pain in people with knees discordant for knee pain in two cohorts.

Design: Within person, knee matched, case-control study.

Setting and participants: Participants in the Multicenter Osteoarthritis (MOST) and Framingham Osteoarthritis studies who had knee radiographs and assessments of knee pain.

Main outcome measures: Association of each pain measure (frequency, consistency, and severity) with radiographic osteoarthritis, as assessed by Kellgren and Lawrence grade (0-4) and osteophyte and joint space narrowing grades (0-3) among matched sets of two knees within individual participants whose knees were discordant for pain status.

Results: 696 people from MOST and 336 people from Framingham were included. Kellgren and Lawrence grades were strongly associated with frequent knee pain-for example, for Kellgren and Lawrence grade 4 v grade 0 the odds ratio for pain was 151 (95% confidence interval 43 to 526) in MOST and 73 (16 to 331) in Framingham (both P<0.001 for trend). Similar results were also seen for the relation of Kellgren and Lawrence scores to consistency and severity of knee pain. Joint space narrowing was more strongly associated with each pain measure than were osteophytes.

Conclusions: Using a method that minimises between person confounding, this study found that radiographic osteoarthritis and individual radiographic features of osteoarthritis were strongly associated with knee pain.

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Conflict of interest statement

Competing interests: None declared.

Figures

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Fig 1 Associations of frequent knee pain with Kellgren and Lawrence (KL) grade among people with two knees discordant for frequent knee pain status. No of case knees (those with frequent knee pain) and control knees (those without frequent knee pain) shown beneath graph for each KL grade. Note that y axis is logarithmically scaled
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Fig 2 Associations of maximal osteophyte (OST) and joint space narrowing (JSN) grades, mutually adjusted for one another, with frequent knee pain among people with two knees discordant for frequent knee pain status. Note that y axis is logarithmically scaled
See this image and copyright information in PMC

Comment in

References

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