Skip to main content

Advertisement

Log in

The correlation between radiographic knee OA and clinical symptoms—do we know everything?

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

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

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. 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

    Article  CAS  PubMed  Google Scholar 

  2. 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

    Article  PubMed Central  PubMed  Google Scholar 

  3. Creamer P, Lethbridge-Cejku M, Hochberg MC (2000) Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatology 39:490–496

    Article  CAS  PubMed  Google Scholar 

  4. 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

    Google Scholar 

  5. Badley EM (1995) The effect of osteoarthritis on disability and health care use in Canada. J Rheumatol Suppl 43:19–22

    CAS  PubMed  Google Scholar 

  6. 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

    PubMed  Google Scholar 

  7. 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

    Article  PubMed Central  PubMed  Google Scholar 

  8. Bellamy N (2002) WOMAC: a 20-year experiential review of a patient-centered self-reported health status questionnaire. J Rheumatol 29:2473–2476

    PubMed  Google Scholar 

  9. 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

    CAS  PubMed  Google Scholar 

  10. Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. 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

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. 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

    Article  CAS  PubMed  Google Scholar 

  13. 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

    Article  CAS  PubMed  Google Scholar 

  14. 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

    Article  CAS  PubMed  Google Scholar 

  15. 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

    Article  Google Scholar 

  16. 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

    Article  CAS  PubMed  Google Scholar 

  17. Jonckheere AR (1954) A distribution free k-sample test against ordered alternatives. Biometrika 41:133–145

    Article  Google Scholar 

  18. 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

    Article  Google Scholar 

  19. Silvapulle MJ, Sen PK (2005) Constrained statistical inference. John Wiley & Sons

  20. Zou KH, Tuncali K, Silverman SG (2003) Correlation and simple linear regression. Radiology 227:617–628

    Article  PubMed  Google Scholar 

  21. 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

    Article  PubMed  Google Scholar 

Download references

Disclosures

None.

Financial disclosures

This study was not funded in any way.

Ethical approval

The study was approved by the institutional ethic committee (No. NCT00767780). For this type of study, formal consent is not required.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Amir Herman.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-015-2871-8

Keywords

Navigation