Abstract
BackgroundThe progressive nature of knee osteoarthritis (OA) leads to not only to physical but also to psychosocial decline; this aspect can influence knee pain experience, manifestations and inevitably diagnostic accuracy.To analyze the role of depressive symptoms on the association between radiographic OA and knee pain, understanding the ability of knee pain symptoms to find out individuals with radiographic OA.MethodsData on 663 subjects was obtained by interview using a structured questionnaire on social, demographic, behavioural and clinical data. Painful knee was assessed regarding having pain: ever, in the last year, in the last 6 months and in the last month. Using factor analysis, participants were graded using a knee pain score, with higher scores representing more symptomatology. Depressive symptoms were evaluated with the Beck Depressive Inventory (BDI), and radiographic knee OA was classified using the Kellgren Lawrence (KL) scale; those with KL ≥ 2 were considered as having radiographic OA.ResultsKnee pain was reported by 53.2% of those with radiographic KL ≥ 2 and by 33.2% of those with radiographic KL < 2. The prevalence of depressive symptoms (BDI > 14) was 19.9% among participants with radiographic KL ≥ 2 and 12.6% among those with radiographic KL < 2 (p = 0.01). The association of knee pain with radiographic knee OA was higher in higher pain scores and in participants without depressive symptoms. Among participants with BDI ≤ 14 the likelihood ratio to identify patients with radiographic knee OA increased with increased pain scores: 1.02 for score 1; 2.19 for score 2 and 7.34 when participants responded positively to all pain questions (score 3). Among participants with depressive symptoms (BDI > 14) likelihood ratios were 0.51, 1.92, 1.82, respectively. The results were similar for both genders.ConclusionsKnee pain scores increased ability to identify participants with radiographic KL ≥ 2 in both sexes. However, the presence of depressive symptoms impairs the ability of knee pain complaints to identify patients with radiographic OA.
Highlights
The progressive nature of knee osteoarthritis (OA) leads to to physical and to psychosocial decline; this aspect can influence knee pain experience, manifestations and inevitably diagnostic accuracy
We found that participants with higher pain scores had higher odds of having depressive symptoms
Among participants with Beck Depressive Inventory (BDI) ≤ 14 the likelihood ratio to identify patients with radiographic knee OA increased with increased pain scores reaching 7.34 when participants responded positively to all pain questions
Summary
The progressive nature of knee osteoarthritis (OA) leads to to physical and to psychosocial decline; this aspect can influence knee pain experience, manifestations and inevitably diagnostic accuracy. Among the most common joint sites affected by OA, the knee is one of the most prevalent [6]. The knee is a weight-bearing joint, essential for function, and frequently associated with more reported pain in OA [6,7,8]. Accurate diagnosis and timely intervention is essential to minimize the consequences of knee OA and to slow its progress [9]. Knee OA diagnosis is based on radiographic changes and clinical examination [10]. Beside the radiographic evaluation, three symptoms (persistent knee pain, limited morning stiffness and reduced function) and three signs (crepitus, restricted movement and bony enlargement) were considered the most useful in the identification of OA patients [11]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
