Association Between Pain and Radiological Changes in Patients with Knee Osteoarthritis
Article Sidebar
Main Article Content
Abstract
Background: Knee osteoarthritis (OA) is a leading cause of disability worldwide, characterized by joint degeneration, pain, and functional limitations. Despite the prevalence of knee OA, the relationship between radiographic changes and the severity of pain remains complex. Previous studies have offered conflicting views on the association between structural joint alterations and clinical symptoms.
Objective: The aim of this study was to investigate the association between radiographic degenerative changes in the knee, as classified by the Kellgren and Lawrence grading system, and the severity of resting pain measured using the Numeric Pain Rating Scale (NPRS).
Methods: This cross-sectional study was conducted on 70 patients diagnosed with knee OA at multiple healthcare facilities in Lahore, Pakistan, from July 2022 to January 2023. Participants aged between 40 and 80 years, both males and females, were included. The severity of knee OA was determined using the Kellgren-Lawrence grading system through X-ray evaluations. Pain severity was assessed using the NPRS. Data were analyzed using SPSS version 25.0, with chi-square tests applied to explore the association between radiographic grades of knee OA and pain severity.
Results: The distribution of knee OA severity among participants was as follows: Grade I (22.9%), Grade II (25.7%), Grade III (32.9%), and Grade IV (18.6%). Pain severity reported by participants was predominantly mild (55.7%), followed by moderate (37.1%) and severe (7.1%). Statistical analysis revealed a significant association between the grade of knee OA and the severity of resting pain (Chi-square = 30.06, p < 0.0001), indicating that higher grades of knee OA were correlated with increased pain severity.
Conclusion: The study confirmed a significant association between radiographic degenerative changes in knee OA and the severity of resting pain. These findings suggest the need for comprehensive clinical assessments in patients with knee OA, incorporating both radiographic evaluations and pain severity measures to guide management and treatment strategies.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Das P, Jana S, Kumar Nandi S. Biomaterial‐Based Therapeutic Approaches to Osteoarthritis and Cartilage Repair Through Macrophage Polarization. The Chemical Record. 2022;22(9):e202200077.
Arslan IG, Damen J, de Wilde M, van den Driest JJ, Bindels PJ, van der Lei J, et al. Incidence and prevalence of knee osteoarthritis using codified and narrative data from electronic health records: a population‐based study. Arthritis Care & Research. 2022;74(6):937-44.
Hattori T, Shimo K, Niwa Y, Tokiwa Y, Matsubara T. Association of chronic pain with radiologic severity and central sensitization in hip osteoarthritis patients. Journal of pain research. 2021:1153-60.
Wilcox S, Brenes GA, Levine D, Sevick MA, Shumaker SA, Craven T. Factors related to sleep disturbance in older adults experiencing knee pain or knee pain with radiographic evidence of knee osteoarthritis. Journal of the American Geriatrics Society. 2000;48(10):1241-51.
Teichtahl A, Wluka AE, Davies-Tuck ML, Cicuttini FM. Imaging of knee osteoarthritis. Best Practice & Research Clinical Rheumatology. 2008;22(6):1061-74.
Hart D, Spector T, Brown P, Wilson P, Doyle D, Silman A. Clinical signs of early osteoarthritis: reproducibility and relation to x ray changes in 541 women in the general population. Annals of the Rheumatic Diseases. 1991;50(7):467-70.
Davis M, Ettinger W, Neuhaus J, Barclay J, Segal M. Correlates of knee pain among US adults with and without radiographic knee osteoarthritis. The Journal of rheumatology. 1992;19(12):1943-9.
Wang T, Liang Y, Li H, Li H, He Q, Xue Y, et al. Single nucleotide polymorphisms and osteoarthritis: an overview and a meta-analysis. Medicine. 2016;95(7).
Van Ginckel A, Bennell KL, Campbell PK, Wrigley TV, Hunter DJ, Hinman RS. Location of knee pain in medial knee osteoarthritis: patterns and associations with self-reported clinical symptoms. Osteoarthritis and Cartilage. 2016;24(7):1135-42.
Duncan R, Hay E, Saklatvala J, Croft P. Prevalence of radiographic osteoarthritis—it all depends on your point of view. Rheumatology. 2006;45(6):757-60.
Gossec L, Jordan J, Mazzuca S, Lam M-A, Suarez-Almazor M, Renner J, et al. Comparative evaluation of three semi-quantitative radiographic grading techniques for knee osteoarthritis in terms of validity and reproducibility in 1759 X-rays: report of the OARSI–OMERACT task force. Osteoarthritis and cartilage. 2008;16(7):742-8.
Bedson J, Croft PR. The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC musculoskeletal disorders. 2008;9(1):1-11.
Peat G, Thomas E, Duncan R, Wood L, Wilkie R, Hill J, et al. Estimating the probability of radiographic osteoarthritis in the older patient with knee pain. Arthritis Care & Research: Official Journal of the American College of Rheumatology. 2007;57(5):794-802.
Özden F, Karaman ÖN, Tuğay N, Kilinç CY, Kilinç RM, Tuğay BU. The relationship of radiographic findings with pain, function, and quality of life in patients with knee osteoarthritis. Journal of Clinical Orthopaedics and Trauma. 2020;11:S512-S7.
Muraki S, Oka H, Akune T, Mabuchi A, En-Yo Y, Yoshida M, et al. Prevalence of radiographic knee osteoarthritis and its association with knee pain in the elderly of Japanese population-based cohorts: the ROAD study. Osteoarthritis and cartilage. 2009;17(9):1137-43.
Bryk FF, Dos Reis AC, Fingerhut D, Araujo T, Schutzer M, Cury RdPL, et al. Exercises with partial vascular occlusion in patients with knee osteoarthritis: a randomized clinical trial. Knee Surgery, Sports Traumatology, Arthroscopy. 2016;24:1580-6.
Kellgren J, Lawrence J. Osteo-arthrosis and disk degeneration in an urban population. Annals of the rheumatic diseases. 1958;17(4):388.
고태성. Reliability and validity of the Korean Western Ontario and McMaster Universities (WOMAC) osteoarthritis index in patients with osteoarthritis of the knee. Journal of Korean Medicine Rehabilitation. 2009;19(2):251-60.
Salaffi F, Carotti M, Stancati A, Grassi W. Health-related quality of life in older adults with symptomatic hip and knee osteoarthritis: a comparison with matched healthy controls. Aging clinical and experimental research. 2005;17:255-63.
Lanyon P, O’Reilly S, Jones A, Doherty M. Radiographic assessment of symptomatic knee osteoarthritis in the community: definitions and normal joint space. Annals of the rheumatic diseases. 1998;57(10):595-601.
Pereira D, Severo M, Santos RA, Barros H, Branco J, Lucas R, et al. Knee and hip radiographic osteoarthritis features: differences on pain, function and quality of life. Clinical rheumatology. 2016;35:1555-64.
Hunter DJ, Schofield D, Callander E. The individual and socioeconomic impact of osteoarthritis. Nature Reviews Rheumatology. 2014;10(7):437-41.
Faber BG, Ebsim R, Saunders FR, Frysz M, Lindner C, Gregory JS, et al. Osteophyte size and location on hip DXA scans are associated with hip pain: findings from a cross sectional study in UK Biobank. Bone. 2021;153:116146.
Tüzün E, Eker L, Aytar A, Daşkapan A, Bayramoğlu M. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis and cartilage. 2005;13(1):28-33.