286 A SYSTEMATIC REVIEW OF THE ASSOCIATION BETWEEN RADIOGRAPHIC AND CLINICAL FEATURES OF HIP AND KNEE OSTEOARTHRITIS: THE IMPORTANCE OF METHODOLOGICAL QUALITY

Abstract

on the outcome variables: WOMAC pain score, WOMAC physical functioning score, SF36 Physical Component Summary (PCS) and SF36 Mental Component Summary (MCS). Results: In CHECK 1002 participants were included, mean age of 56 years, mean BMI of 26 kg/m2 and 79% female. 76% of participants with knee symptoms fulfilled the clinical ACR criteria for classification of OA at the start and 24% participants with early hip OA fulfilled the clinical classification criteria of hip OA. Over 67% of the total study population had comorbidity: severe or persistent disorders of neck, shoulder, elbow, wrist or hand (23%), hypertension (20%) and severe or persistent back disorders (18%) were most prevalent. The results indicate that the pain score and physical function score on the WOMAC deteriorates with about 3 and 4 points respectively with every (extra) comorbidity. The physical and mental status of the SF36 deteriorates with respectively about 2 and 1 point with every (extra) comorbidity. Results of the final model (controlling for age, gender, Kellgren & Lawrence grade) show that severe back disorders have the most negative effect on WOMAC pain, physical functioning and one of the most negative effects on physical status of SF36. The presence of this disorder increases WOMAC pain score on average with 7 points, WOMAC function score with 8 points, and SF36 PCS score with 4 points. The mental status was negatively influenced by the presence of duodenal/ulcera, thyroid disease, and migraine or regular headache. Conclusions: In the early stage of osteoarthritis the effect of the presence of especially diseases in the locomotor system have negative effect on complaints and health status. The clinical implications are that to improve the physical health of participants with early OA of knee and/or hip not only the complaints related to OA have to be treated but also the additional diseases, especially back, neck, shoulder, elbow, wrist or hand disorders or obesity. Apart from the physical status also the mental status is affected in the early stage of OA by the presence of comorbidity and this is a further reason to take comorbidity into account in the management of early OA.