Abstract
This study aims to evaluate the correlations between common clinical osteoarthritis (OA) diagnostic tools in order to determine the value of each. A secondary goal was to investigate the influence of gender differences on the findings. Five hundred and eighteen patients with knee OA were evaluated using the Western Ontario and McMaster Osteoarthritis Index (WOMAC) questionnaire, short form 36 (SF-36) Health Survey, and plain radiographs. Analysis of variance (ANOVA) was used to compare the different domains of the WOMAC and SF-36 questionnaires between genders and the radiographic scale. Higher knee OA x-ray grade were associated with worse clinical outcome: for women, higher scores for the WOMAC pain, function and final scores and lower scores in the SF-36 final score; in men, lower SF-36 overall and physical domains scores. Gender differences were found in all clinical scores that were tested, with women having worse clinical scores for similar radiographic grading (p values <0.001). Knee radiographs for OA have an important role in the clinical evaluation of the patient. Patients with higher levels of knee OA in x-ray have a higher probability of having a worse clinical score in the WOMAC and SF-36 scores. The gender differences suggest that for similar knee OA x-ray grade, women’s clinical scores are lower.
Trial registration: NCT00767780
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References
Sun Y, Sturmer T, Gunther KP, Brenner H (1997) Reliability and validity of clinical outcome measurements of osteoarthritis of the hip and knee—a review of the literature. Clin Rheumatol 16:185–198
Rosemann T, Joos S, Koerner T, Szecsenyi J, Laux G (2006) Comparison of AIMS2-SF, WOMAC, x-ray and a global physician assessment in order to approach quality of life in patients suffering from osteoarthritis. BMC Musculoskelet Disord 7:6
Creamer P, Lethbridge-Cejku M, Hochberg MC (2000) Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatology 39:490–496
Puhl W (1994) The importance of clinical subsets of osteoarthritis for epiderniological research. In: Puhl W, Brandt KD (eds) Epidemiology of Osteoarthritis. Georg Thieme Verlag Stuttgart, New York, pp 76–89
Badley EM (1995) The effect of osteoarthritis on disability and health care use in Canada. J Rheumatol Suppl 43:19–22
Dillon CF, Rasch EK, Gu Q, Hirsch R (2006) Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991–94. J Rheumatol 33:2271–2279
Debi R, Mor A, Segal O, Segal G, Debbi E, Agar G, Halperin N, Haim A, Elbaz A (2009) Differences in gait patterns, pain, function and quality of life between males and females with knee osteoarthritis: a clinical trial. BMC Musculoskelet Disord 10:127
Bellamy N (2002) WOMAC: a 20-year experiential review of a patient-centered self-reported health status questionnaire. J Rheumatol 29:2473–2476
Kosinski M, Keller SD, Ware JE Jr, Hatoum HT, Kong SX (1999) The SF-36 Health Survey as a generic outcome measure in clinical trials of patients with osteoarthritis and rheumatoid arthritis: relative validity of scales in relation to clinical measures of arthritis severity. Med Care 37(Suppl 5):MS23–MS39
Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502
Duncan R, Peat G, Thomas E, Hay E, McCall I, Croft P (2007) Symptoms and radiographic osteoarthritis: not as discordant as they are made out to be? Ann Rheum Dis 66:86–91
Roos EM, Klassbo M, Lohmander LS (1999) WOMAC osteoarthritis index. Reliability, validity, and responsiveness in patients with arthroscopically assessed osteoarthritis. Western Ontario and MacMaster Universities. Scand J Rheumatol 28:210–215
Wigler I, Neumann L, Yaron M (1999) Validation study of a Hebrew version of WOMAC in patients with osteoarthritis of the knee. Clin Rheumatol 18:402–405
Lewin-Epstein N, Sagiv-Schifter T, Shabtai EL, Shmueli A (1998) Validation of the 36-item Short-Form Health Survey (Hebrew version) in the adult population of Israel. Med Care 36:1361–1370
Neogi T, Felson D, Niu J, Nevitt M, Lewis CE, Aliabadi P et al (2009) Association between radiographic features of knee osteoarthritis and pain: results from two cohort studies. BMJ 339:1–7
Altman R, Asch E, Bloch D et al (1986) Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 29:1039–1049
Jonckheere AR (1954) A distribution free k-sample test against ordered alternatives. Biometrika 41:133–145
Terpstra TJ (1952) The asymptotic normality and consistency of Kandall’s test against trend when ties are present in one ranking. Indag Math 14:327–333
Silvapulle MJ, Sen PK (2005) Constrained statistical inference. John Wiley & Sons
Zou KH, Tuncali K, Silverman SG (2003) Correlation and simple linear regression. Radiology 227:617–628
Szebenyi B, Hollander AP, Dieppe P et al (2006) Associations between pain, function, and radiographic features in osteoarthritis of the knee. Arthritis Rheum 54:230–235
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This study was not funded in any way.
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The study was approved by the institutional ethic committee (No. NCT00767780). For this type of study, formal consent is not required.
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Herman, A., Chechik, O., Segal, G. et al. The correlation between radiographic knee OA and clinical symptoms—do we know everything?. Clin Rheumatol 34, 1955–1960 (2015). https://doi.org/10.1007/s10067-015-2871-8
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DOI: https://doi.org/10.1007/s10067-015-2871-8