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Comparative Study
. 2018 Jan;30(1):17-25.
doi: 10.1007/s40520-017-0847-z. Epub 2017 Nov 3.

Concordance between clinical and radiographic evaluations of knee osteoarthritis

Camille Parsons  1 , Nicholas R Fuggle  1 , Mark H Edwards  1   2 , Lyndsey Goulston  1 , Anna E Litwic  1 , Darshan Jagannath  1 , Suzan van der Pas  3 , Cyrus Cooper  4   5   6 , Elaine M Dennison  1 ; EPOSA Research Group
Affiliations
Comparative Study

Concordance between clinical and radiographic evaluations of knee osteoarthritis

Camille Parsons et al. Aging Clin Exp Res. 2018 Jan.

Abstract

Background: Significant correlation has been previously demonstrated between radiographic and clinical diagnoses of knee osteoarthritis (OA); however, the specific findings on clinical examination that relate best to a radiographic diagnosis have not been fully elicited.

Aims: We aimed to explore the relationship between clinical symptoms and physical findings with radiographic diagnoses of tibiofemoral and patellofemoral OA.

Methods: This study was based on 409 individuals from the Hertfordshire Cohort Study, born between 1931 and 1939. Antero-posterior and lateral radiographs were taken of both knees. The presence of tibiofemoral and patellofemoral OA was defined according to the Kellgren and Lawrence score. Clinical symptoms, assessed using WOMAC, and physical findings were ascertained by examination. Relationships were assessed using multilevel univariate logistic regression.

Results: In the 775 knees studied, the prevalence of physical findings was crepitus (25%), tibiofemoral tenderness (15%), bony swelling (12%), and pain on flexion (10%). Thirty-one percent (n = 238) knees demonstrated tibiofemoral OA, 28% (n = 220) showed patellofemoral OA, and 16% demonstrated OA in both locations. A global clinical symptom score was associated with increased risk of tibiofemoral OA (OR 12.5, 95% CI 5.4-29.0) and patellofemoral OA (OR 5.1, 95% CI 2.3-13.1). On clinical examination, the presence of crepitus, tibiofemoral tenderness, bony swelling, and pain on flexion was associated with increased risk of tibiofemoral OA; however, only tenderness was found to be associated with patellofemoral OA.

Conclusion: Global clinical symptom score was associated with radiographic tibiofemoral and patellofemoral OA. However, individual clinical signs were more strongly associated with tibiofemoral than patellofemoral OA.

Keywords: Epidemiology; Osteoarthritis; Patellofemoral; Radiography; Tibiofemoral.

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Conflict of interest statement

Conflict of interest

Cyrus Cooper has received consultancy fees and honoraria from Servier; Eli Lilly; Pfizer; Merck; Amgen; Alliance; Novartis; Medtronic; GSK; Takeda; Roche and UCB. Camille Parsons, Nicholas Fuggle, Mark Edwards, Lyndsey Goulston, Anna Litwic, Darshan Jagannath, Suzan van der Pas and Elaine Dennison have no conflicts of interest.

Ethical approval

The UK component of EPOSA had ethical approval from the Hertfordshire Research Ethics Committee, reference number 10/h0311/59.

Statement of human and animal rights

All procedures performed in this study involving human participants were in accordance with the ethical approval and standards of the institutional and regional research committee.

Informed consent

All participants gave written informed consent.

Figures

Fig. 1
Fig. 1
Venn diagram showing the overlap between tibiofemoral and patellofemoral radiographic knee OA
Fig. 2
Fig. 2
Relationship between WOMAC knee symptoms and radiographic knee OA
Fig. 3
Fig. 3
Relationship between physical findings and radiographic knee OA
See this image and copyright information in PMC

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