Prevalence of radiographic osteoarthritis - it all depends on your point of view
Prevalence of radiographic osteoarthritis - it all depends on your point of view
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DOI：
10.1093/rheumatology/kei270
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发表时间：
2006-06-01
期刊：
影响因子：
5.5
通讯作者：
Croft, P. R.
中科院分区：
文献类型：
--
作者：
Duncan, R. C.;Hay, E. M.;Croft, P. R.
目标.老年人在明显没有放射学骨关节炎的情况下可能会发生膝盖疼痛和残疾。然而，选择的观点来定义放射学骨关节炎可能是至关重要的。我们采用三种不同的影像学检查方法，对膝关节疼痛患者的骨关节炎的患病率和房室分布进行了研究。我们对819名50岁及以上患有膝关节疼痛的成年人进行了一项基于人群的研究（临床评估研究-膝关节[CAS（K）]的一部分）。获得三个影像学视图：负重后前位（PA）半屈曲/跖骨后角视图;仰卧位Skyline视图;仰卧位外侧视图。777名受试者的所有三个视图的完整数据可用。间室放射学骨关节炎的分布为314例（40%）合并胫股/髌股，186例（24%）单独髌股，31例（4%）单独胫股和246例（32%）正常。因此，在该症状人群中，放射学骨关节炎的总体患病率为531/777（68.3%）。使用PA视图（仅反映胫股骨关节炎）将识别531例中的56.7%，而添加天际线或侧视图将其提高到87.0%。除PA视图外，使用天际线和侧位视图时，98.7%的放射学骨关节炎病例被识别。除患病率外，当使用不同的视图组合时，房室分布也发生了显著变化。多个视图比单视图检测更多的放射学骨关节炎。当使用不同的视图组合时，骨关节炎的患病率和房室分布发生变化，这可能会改变症状和影像学变化之间公认的关系或缺乏关系。
Objectives. Knee pain and disability in older people may occur in the apparent absence of radiographic osteoarthritis. However, the view chosen to define radiographic osteoarthritis may be critical. We have investigated the prevalence and compartmental distribution of radiographic osteoarthritis in people with knee pain using different combinations of three separate radiographic views.Methods. We performed a population-based study of 819 adults aged 50 yr and over with knee pain (part of the Clinical Assessment Study - Knee [CAS(K)]). Three radiographic views were obtained: weight-bearing posteroanterior (PA) semiflexed/metatarsophatangeal view; supine skyline; and supine lateral.Results. Complete data for all three views were available on 777 subjects. The distribution of compartmental radiographic osteoarthritis was 314 (40%) combined tibiofemoral/patellofemoral, 186 (24%) isolated patellofemoral, 31 (4%) isolated tibiofemoral and 246 (32%) normal. Hence, the overall prevalence of radiographic osteoarthritis was 531/777 (68.3%) in this symptomatic population. Using a PA view atone (reflecting tibiofemoral osteoarthritis only) would identify 56.7% of the 531, whilst the addition of a skyline or lateral view increased this to 87.0%. When using both skyline and lateral views in addition to the PA view, 98.7% cases of radiographic osteoarthritis were identified. In addition to prevalence, compartmental distribution altered markedly when different combinations of views were used.Conclusions. Multiple views detect more radiographic osteoarthritis than single views alone. When different combinations of views are used, the prevalence and compartmental distribution of osteoarthritis changes and this may alter the accepted relationship, or lack of it, between symptoms and radiographic change.