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Knee and hip radiographic osteoarthritis features: differences on pain, function and quality of life

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Abstract

The association between radiographic osteoarthritis (OA) and symptoms is inconsistent and variable according to each joint. The purpose of this study is to understand the relation between radiographic OA features, pain, function and quality of life, in knee and hip joints. A cross-sectional study was performed using information from EPIPorto cohort. Data was obtained by interview using a structured questionnaire on social, demographic, behavioural and clinical data. Pain was assessed using a pain frequency score (regarding ever having knee pain, pain in the last year, in the last 6 months and in the last month). Quality of life was evaluated with Short Form 36 (SF-36) and function disability with the Lequesne knee and hip indexes. Radiographic knees and hips were classified using the Kellgren–Lawrence score (KL 0–4). Linear regression and proportional odds ratios estimated the association between radiographic features, pain, function and quality of life. In our study, symptomatic OA (KL ≥ 2 plus joint pain) was 26.0 % in knee and 7.0 % hip joints. In knee, the increase on radiographic score increased the odds to have a higher pain frequency score [1.58 (95 % CI = 1.27, 1.97)] and was associated [adjusted β (95 % CI)] with worst general health [−3.05 (−5.00, −1.09)], physical function [−4.92 (−7.03, −2.80)], role-physical [−4.10 (−8.08, −0.11)], bodily pain [−2.96 (−5.45, −0.48)] and limitations in activities of daily living [0.48 (0.08, 0.89)]. Regarding hip, no significant associations were found between the severity of radiographic lesions and these measures. Radiographic lesions in knee were associated with higher complaints, as far as pain and functional limitations are concerned, compared with hip.

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References

  1. Felson DT (2009) Developments in the clinical understanding of osteoarthritis. Arthritis Res Ther 11(1):203. doi:10.1186/ar2531

    Article  PubMed  PubMed Central  Google Scholar 

  2. Zhang W, Doherty M, Peat G, Bierma-Zeinstra MA, Arden NK, Bresnihan B et al (2010) EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis. Ann Rheum Dis 69(3):483–489

    Article  CAS  PubMed  Google Scholar 

  3. Arden N, Nevitt MC (2006) Osteoarthritis: epidemiology. Best Pract Res Clin Rheumatol 20(1):3–25

    Article  PubMed  Google Scholar 

  4. Pereira D, Peleteiro B, Araujo J, Branco J, Santos RA, Ramos E (2011) The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review. Osteoarthr Cartil 19(11):1270–1285

    Article  CAS  PubMed  Google Scholar 

  5. Duncan RC, Hay EM, Saklatvala J, Croft PR (2006) Prevalence of radiographic osteoarthritis—it all depends on your point of view. Rheumatology (Oxford) 45(6):757–760

    Article  CAS  Google Scholar 

  6. Lawrence RC, Helmick CG, Arnett FC, Deyo RA, Felson DT, Giannini EH et al (1998) Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum 41(5):778–799

    Article  CAS  PubMed  Google Scholar 

  7. Woolf A, Pfleger B (2003) Burden of major musculoskeletal conditions. Bull World Health Organ 81(9):646–656

    PubMed  PubMed Central  Google Scholar 

  8. Kinds MB, Welsing PM, Vignon EP, Bijlsma JW, Viergever MA, Marijnissen AC et al (2011) A systematic review of the association between radiographic and clinical osteoarthritis of hip and knee. Osteoarthr Cartil 19(7):768–778

    Article  CAS  PubMed  Google Scholar 

  9. McAlindon TE, Cooper C, Kirwan JR, Dieppe PA (1993) Determinants of disability in osteoarthritis of the knee. Ann Rheum Dis 52(4):258–262

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Bedson J, Croft PR (2008) The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC Musculoskelet Disord 9:116. doi:10.1186/471-2474-9-116

    Article  PubMed  PubMed Central  Google Scholar 

  11. Dahaghin S, Bierma-Zeinstra SM, Ginai AZ, Pols HA, Hazes JM, Koes BW (2005) Prevalence and pattern of radiographic hand osteoarthritis and association with pain and disability (the Rotterdam study). Ann Rheum Dis 64(5):682–687

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Hannan MT, Felson DT, Pincus T (2000) Analysis of the discordance between radiographic changes and knee pain in osteoarthritis of the knee. J Rheumatol 27(6):1513–1517

    CAS  PubMed  Google Scholar 

  13. Felson DT, Zhang Y (1998) An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum 41(8):1343–1355

    Article  CAS  PubMed  Google Scholar 

  14. Kopec JA, Rahman MM, Berthelot JM, Le Petit C, Aghajanian J, Sayre EC et al (2007) Descriptive epidemiology of osteoarthritis in British Columbia, Canada. J Rheumatol 34(2):386–393

    PubMed  Google Scholar 

  15. Chan KKW, Wu RWK (2012) Symptoms, signs and quality of life (QoL) in osteoarthritis (OA). In: Principles of osteoarthritis- its definition, character, derivation and modality-related recognition [internet]. Available from: http://www.intechopen.com/books/principles-of-osteoarthritis-its-definition-character-derivation-and-modalityrelated-recognition/symptoms-signs-and-quality-of-life-qol-in-osteoarthritis-oa

  16. Creamer P, Lethbridge-Cejku M, Hochberg MC (1999) Determinants of pain severity in knee osteoarthritis: effect of demographic and psychosocial variables using 3 pain measures. J Rheumatol 26(8):1785–1792

    CAS  PubMed  Google Scholar 

  17. Creamer P, Lethbridge-Cejku M, Hochberg MC (2000) Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatology (Oxford) 39(5):490–496

    Article  CAS  Google Scholar 

  18. 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(1):86–91

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Ramos E, Lopes C, Barros H (2004) Investigating the effect of nonparticipation using a population-based case–control study on myocardial infarction. Ann Epidemiol 14(6):437–441

    Article  PubMed  Google Scholar 

  20. Huskisson EC (1982) Measurement of pain. J Rheumatol 9(5):768–769

    CAS  PubMed  Google Scholar 

  21. Pereira D, Severo M, Ramos E, Branco J, Santos RA, Costa L et al (2015) Potential role of age, sex, body mass index and pain to identify patients with knee osteoarthritis. Int J Rheum Dis. doi:10.1111/1756-185X.12611

    PubMed  Google Scholar 

  22. Vaz-Serra A, Abreu J (1973) Aferição dos quadros clínicos depressivos: I. Ensaio de aplicação do inventário depressivo de beck a uma amostra Portuguesa de doentes deprimidos. Coimbra Med 20:623–644

    Google Scholar 

  23. Severo M, Santos AC, Lopes C, Barros H (2006) Reliability and validity in measuring physical and mental health construct of the Portuguese version of MOS SF-36. Acta Med Port 19(4):281–287

    PubMed  Google Scholar 

  24. Lucas R, Rocha O, Bastos J, Costa L, Barros H, Lunet N (2009) Pharmacological management of osteoporosis and concomitant calcium supplementation in a Portuguese urban population: the EpiPorto study (2005–2007). Clin Exp Rheumatol 27(1):47–53

    CAS  PubMed  Google Scholar 

  25. Dawson J, Linsell L, Doll H, Zondervan K, Rose P, Carr A et al (2005) Assessment of the Lequesne index of severity for osteoarthritis of the hip in an elderly population. Osteoarthr Cartil 13(10):854–860

    Article  CAS  PubMed  Google Scholar 

  26. Faucher M, Poiraudeau S, Lefevre-Colau MM, Rannou F, Fermanian J, Revel M (2003) Assessment of the test-retest reliability and construct validity of a modified Lequesne index in knee osteoarthritis. Joint Bone Spine 70(6):521–525

    Article  PubMed  Google Scholar 

  27. LaValley MP, McLaughlin S, Goggins J, Gale D, Nevitt MC, Felson DT (2005) The lateral view radiograph for assessment of the tibiofemoral joint space in knee osteoarthritis: its reliability, sensitivity to change, and longitudinal validity. Arthritis Rheum 52(11):3542–3547

    Article  PubMed  Google Scholar 

  28. Auleley GR, Giraudeau B, Dougados M, Ravaud P (2000) Radiographic assessment of hip osteoarthritis progression: impact of reading procedures for longitudinal studies. Ann Rheum Dis 59(6):422–427

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. O’Reilly SC, Muir KR, Doherty M (1996) Screening for pain in knee osteoarthritis: which question? Ann Rheum Dis 55(12):931–933

    Article  PubMed  PubMed Central  Google Scholar 

  30. Pereira D, Severo M, Barros H, Branco J, Santos RA, Ramos E (2013) The effect of depressive symptoms on the association between radiographic osteoarthritis and knee pain: a cross-sectional study. BMC Musculoskelet Disord 14:214

    Article  PubMed  PubMed Central  Google Scholar 

  31. 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(5 Suppl):MS23–MS39

    CAS  PubMed  Google Scholar 

  32. Davis MA, Ettinger WH, Neuhaus JM, Barclay JD, Segal MR (1992) Correlates of knee pain among US adults with and without radiographic knee osteoarthritis. J Rheumatol 19(12):1943–1949

    CAS  PubMed  Google Scholar 

  33. Salaffi F, Carotti M, Stancati A, Grassi W (2005) Health-related quality of life in older adults with symptomatic hip and knee osteoarthritis: a comparison with matched healthy controls. Aging Clin Exp Res 17(4):255–263

    Article  PubMed  Google Scholar 

  34. Amaro A, Amado F, Duarte JA, Appell HJ (2007) Gluteus medius muscle atrophy is related to contralateral and ipsilateral hip joint osteoarthritis. Int J Sports Med 28(12):1035–1039

    Article  CAS  PubMed  Google Scholar 

  35. Duncan R, Peat G, Thomas E, Wood L, Hay E, Croft P (2008) How do pain and function vary with compartmental distribution and severity of radiographic knee osteoarthritis? Rheumatology (Oxford) 47(11):1704–1707

    Article  CAS  Google Scholar 

  36. Hirsch R, Fernandes RJ, Pillemer SR, Hochberg MC, Lane NE, Altman RD et al (1998) Hip osteoarthritis prevalence estimates by three radiographic scoring systems. Arthritis Rheum 41(2):361–368

    Article  CAS  PubMed  Google Scholar 

  37. Gunther KP, Sun Y (1999) Reliability of radiographic assessment in hip and knee osteoarthritis. Osteoarthr Cartil 7(2):239–246

    Article  CAS  PubMed  Google Scholar 

  38. Barker K, Lamb SE, Toye F, Jackson S, Barrington S (2004) Association between radiographic joint space narrowing, function, pain and muscle power in severe osteoarthritis of the knee. Clin Rehabil 18(7):793–800

    Article  PubMed  Google Scholar 

  39. Salaffi F, Cavalieri F, Nolli M, Ferraccioli G (1991) Analysis of disability in knee osteoarthritis. Relationship with age and psychological variables but not with radiographic score. J Rheumatol 18(10):1581–1586

    CAS  PubMed  Google Scholar 

  40. Summers MN, Haley WE, Reveille JD, Alarcon GS (1988) Radiographic assessment and psychologic variables as predictors of pain and functional impairment in osteoarthritis of the knee or hip. Arthritis Rheum 31(2):204–209

    Article  CAS  PubMed  Google Scholar 

  41. Szebenyi B, Hollander AP, Dieppe P, Quilty B, Duddy J, Clarke S et al (2006) Associations between pain, function, and radiographic features in osteoarthritis of the knee. Arthritis Rheum 54(1):230–235

    Article  PubMed  Google Scholar 

  42. van Baar ME, Dekker J, Lemmens JA, Oostendorp RA, Bijlsma JW (1998) Pain and disability in patients with osteoarthritis of hip or knee: the relationship with articular, kinesiological, and psychological characteristics. J Rheumatol 25(1):125–133

    PubMed  Google Scholar 

  43. Parmelee PA, Harralson TL, McPherron JA, DeCoster J, Schumacher HR (2012) Pain, disability, and depression in osteoarthritis: effects of race and sex. J Aging Health 24(1):168–187

    Article  PubMed  Google Scholar 

  44. Laslett LL, Quinn SJ, Winzenberg TM, Sanderson K, Cicuttini F, Jones G (2012) A prospective study of the impact of musculoskeletal pain and radiographic osteoarthritis on health related quality of life in community dwelling older people. BMC Musculoskelet Disord 13:168

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, 4200-319, Porto, Portugal

    Duarte Pereira, Milton Severo, Henrique Barros, Raquel Lucas & Elisabete Ramos

  2. EPI Unit, Public Health Institute, University of Porto, Porto, Portugal

    Duarte Pereira, Milton Severo, Henrique Barros, Raquel Lucas & Elisabete Ramos

  3. Hospital Beatriz Ângelo, Loures, Portugal

    Rui A. Santos

  4. CEDOC, Nova Medical School/Faculdade de Ciências Médicas, Rheumatology Department, Universidade Nova de Lisboa, CHLO, EPE—Hospital Egas Moniz, Lisboa, Portugal

    Jaime Branco

  5. Rheumatology Department, EPE–Hospital S. João, Porto, Portugal

    Lúcia Costa

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  1. Duarte Pereira
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  2. Milton Severo
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  3. Rui A. Santos
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  4. Henrique Barros
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Correspondence to Duarte Pereira.

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Pereira, D., Severo, M., Santos, R.A. et al. Knee and hip radiographic osteoarthritis features: differences on pain, function and quality of life. Clin Rheumatol 35, 1555–1564 (2016). https://doi.org/10.1007/s10067-015-3087-7

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  • DOI: https://doi.org/10.1007/s10067-015-3087-7

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