Symptoms and radiographic osteoarthritis: not as discordant as they are made out to be?
Symptoms and radiographic osteoarthritis: not as discordant as they are made out to be?
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DOI：
10.1136/ard.2006.052548
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发表时间：
2007-01-01
影响因子：
27.4
通讯作者：
Croft, P.
中科院分区：
文献类型：
--
作者：
Duncan, R.;Peat, G.;Croft, P.
目的：关节疼痛和影像学骨关节炎往往是不一致的。目的：通过研究疼痛和残疾的详细性质，以及这与放射学骨关节炎的关系，更密切地调查这一问题。方法：以人群为基础的研究，819名年龄≥ 50岁的膝关节疼痛的成年人。使用经验证的量表（西安大略和麦克马斯特大学（WOMAC）评分）测量膝关节疼痛、僵硬和残疾的严重程度，并记录疼痛持续性。通过慢性疼痛分级量表测量总体严重程度。三个膝关节的影像学意见，获得负重后前跖趾，仰卧天际线和仰卧lateral.Results：745名参与者在过去6个月的膝关节疼痛的资格（平均年龄65岁，338名男性）。影像学骨关节炎更常见于那些有较长的历史和更持久的症状。发现放射学骨关节炎与疼痛严重程度、僵硬度和残疾的WOMAC评分较高相关性更强的趋势（最高与最低WOMAC类别的校正比值比（95%置信区间（CI））分别为：3.7（2.0至6.7）、3.0（2.0至4.6）和2.8（1.6至5.0））。与负重活动有关的疼痛和残疾的WOMAC项目与放射学骨关节炎的相关性最强。结合疼痛持续性和整体严重程度，持续性重度疼痛与放射学骨关节炎发生率显著增加相关（2.6（95%CI 1.5至4.7））。结论：疼痛、僵硬和身体功能的严重程度与放射学骨关节炎的存在之间存在一致的相关性。这项研究强调了潜在的关节疾病对疼痛和残疾程度的潜在贡献。
Objectives: Joint pain and radiographic osteoarthritis are often discordant. Aim: To investigate this issue more closely by studying the detailed nature of pain and disability, and how this relates to radiographic osteoarthritis.Methods: Population-based study of 819 adults aged >= 50 years with knee pain. The severity of knee pain, stiffness and disability was measured using a validated scale (the Western Ontario and McMaster Universities (WOMAC) Score) and pain persistence was recorded. Global severity was measured by the graded chronic pain scale. Three radiographic views of the knees were obtained-weight- bearing posteroanterior metatarsophalangeal, supine skyline and supine lateral.Results: 745 participants with knee pain in the past 6 months were eligible (mean age 65 years, 338 men). Radiographic osteoarthritis was more common in those with a longer history and more persistent symptoms. A strong trend was found of radiographic osteoarthritis being more strongly associated with higher WOMAC scores for pain severity, stiffness and disability (adjusted odds ratio (95% confidence interval (CI)) for highest v lowest WOMAC category: 3.7 (2.0 to 6.7), 3.0 (2.0 to 4.6) and 2.8 (1.6 to 5.0), respectively). Those individual WOMAC items for pain and disability pertaining to weight- bearing mobility were the most strongly associated with radiographic osteoarthritis. Combining pain persistence and global severity, persistent severe pain was associated with a significant increase in the occurrence of radiographic osteoarthritis (2.6 (95% CI 1.5 to 4.7)).Conclusions: A consistent association was found between severity of pain, stiffness and physical function and the presence of radiographic osteoarthritis. This study highlights the potential contribution of underlying joint disease to the degree of pain and disability.