Distinct patterns of variation in the distribution of knee pain.
Distinct patterns of variation in the distribution of knee pain.
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DOI：
10.1038/s41598-018-34950-2
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发表时间：
2018-11-08
影响因子：
4.6
通讯作者：
Rathleff MS
中科院分区：
文献类型：
--
作者：
Boudreau SA;Royo AC;Matthews M;Graven-Nielsen T;Kamavuako EN;Slabaugh G;Thorborg K;Vicenzino B;Rathleff MS
患者使用数字身体地图表达疼痛扩大了探索身体疼痛空间变化的分析机会。青少年和成人常见的膝关节疼痛是髌股疼痛 (PFP)，最近发现 PFP 的特点是疼痛分布不均匀。这些分布是否存在重要模式仍不清楚。这项开创性的研究使用主成分分析和聚类方法评估疼痛的空间变化。 299 名不同性别、年龄和疼痛严重程度的 PFP 患者绘制了详细的膝盖疼痛数字身体图。髌骨上及其周围出现了三种疼痛分布模式，类似于锚形、钩形和卵形。疼痛分布的变化与性别、年龄和疼痛强度无关。双侧疼痛伴有较长的疼痛持续时间，大多数以钩形和卵形疼痛分布为特征。左右膝盖之间的双侧和/或对称疼痛可能代表与长期 PFP 相关的症状。疼痛位置和区域的不同模式表明，不能排除特定的基础结构作为重要的驱动因素，尽管中枢神经元机制可能以疼痛的对称表现为例，可能在患有长期症状的个体中发挥作用。
The patient’s expression of pain using digital-body maps expands analytic opportunities for exploring the spatial variation of bodily pain. A common knee pain condition in adolescents and adults is patellofemoral pain (PFP) and recently PFP was shown to be characterized by a heterogeneous distribution of pain. Whether there are important patterns in these distributions remains unclear. This pioneering study assesses the spatial variation of pain using principal component analysis and a clustering approach. Detailed digital-body maps of knee pain were drawn by 299 PFP patients of mixed sex, age, and pain severity. Three pain distribution patterns emerged resembling an Anchor, Hook, and an Ovate shape on and around the patella. The variations in pain distribution were independent of sex, age, and pain intensity. Bilateral pain associated with a longer duration of pain and the majority characterized by the Hook and Ovate pain distributions. Bilateral and/or symmetrical pain between the left and right knees may represent symptoms associated with longstanding PFP. The distinct patterns of pain location and area suggest specific underlying structures cannot be ruled out as important drivers, although central neuronal mechanisms possibly exemplified by the symmetrical representation of pain may play a role in individuals with longstanding symptoms.