The discordance between clinical and radiographic knee osteoarthritis: A systematic search and summary of the literature
The discordance between clinical and radiographic knee osteoarthritis: A systematic search and summary of the literature
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DOI：
10.1186/1471-2474-9-116
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发表时间：
2008-09-02
影响因子：
2.3
通讯作者：
Croft, Peter R.
中科院分区：
文献类型：
--
作者：
Bedson, John;Croft, Peter R.
背景：研究表明，膝关节骨关节炎(OA)的症状与放射学表现的相关性很弱，反之亦然。我们的目标是确定对患有膝关节疼痛的成人的膝关节骨性关节炎和患有膝关节骨性关节炎的成人的膝关节疼痛的患病率的估计，并确定X射线骨关节炎和症状的定义以及人口统计学因素的变化是否影响这些估计。方法：系统的文献搜索确定结合了膝骨性关节炎的X射线、诊断、临床体征和症状的人群研究。对膝关节疼痛患者中放射性骨性关节炎的患病率进行了评估，反之亦然。结果：膝关节疼痛患者的放射学骨性关节炎比例为15%~76%，膝关节骨关节炎患者的疼痛比例为15%~81%。在X线片、疼痛定义、OA分级和人口统计学因素上有相当大的差异。结论：膝关节疼痛不是膝关节骨关节炎的准确标志，但这取决于所使用的X线片的范围。对于膝关节疼痛或残疾的可能性，放射学膝关节骨性关节炎同样是不准确的指导。这两种联系都受到疼痛定义和研究小组性质的影响。在评估个别膝关节疼痛患者时，不应单独使用膝关节X光检查结果。
Background: Studies have suggested that the symptoms of knee osteoarthritis (OA) are rather weakly associated with radiographic findings and vice versa. Our objectives were to identify estimates of the prevalence of radiographic knee OA in adults with knee pain and of knee pain in adults with radiographic knee OA, and determine if the definitions of x ray osteoarthritis and symptoms, and variation in demographic factors influence these estimates.Methods: A systematic literature search identifying population studies which combined x rays, diagnosis, clinical signs and symptoms in knee OA. Estimates of the prevalence of radiographic OA in people with knee pain were determined and vice versa. In addition the effects of influencing factors were scrutinised.Results: The proportion of those with knee pain found to have radiographic osteoarthritis ranged from 15-76%, and in those with radiographic knee OA the proportion with pain ranged from 15%-81%. Considerable variation occurred with x ray view, pain definition, OA grading and demographic factors.Conclusion: Knee pain is an imprecise marker of radiographic knee osteoarthritis but this depends on the extent of radiographic views used. Radiographic knee osteoarthritis is likewise an imprecise guide to the likelihood that knee pain or disability will be present. Both associations are affected by the definition of pain used and the nature of the study group. The results of knee x rays should not be used in isolation when assessing individual patients with knee pain.