Prevalence Of Radiographic Osteoarthritis Research Articles

Prognostic factors and the value of radiographic osteoarthritis for persistent complaints after referral for ankle radiography

BackgroundAnkle symptoms are a common reason to consult the general practitioner and often persist for years. In a population referred for ankle radiography, the prevalence of radiographic osteoarthritis (OA) is substantial, but its additional predictive value for persistent symptoms is unknown. Therefore, we examined the prognosis of symptoms 2–3 years after referral for ankle radiography, assessed clinical prognostic factors, and the additional predictive value of radiographic OA for persistent ankle complaints. MethodsWe included 893 adults referred for ankle radiography and studied the following candidate prognostic factors at baseline: age, sex, body mass index (BMI), referral for chronic complaints (>3 months), pain during activity (NRS-11) and presence of stiffness and functional loss as predominant symptom. X-rays were scored for radiographic OA. After 2–3 years participants were invited for a follow-up questionnaire including persistence of ankle complaints. To assess prognostic factors for persistent complaints, uni- and multivariable logistic regression were used. ResultsOf the 194 responders at follow-up, ankle complaints persisted in 71(36.6 %). BMI (OR 1.08; 95 % CI 1.01–1.15), stiffness as predominant symptom (OR 1.69; 95 % CI 0.89–3.21), and chronic complaints (OR 2.84; 95 % CI 1.45–5.57) were in the initial model for persistent complaints (AUC=0.69). After adding radiographic OA (OR 2.36; 95 % CI 1.01–5.50), the AUC of the final model became 0.70. ConclusionAnkle complaints persist in a considerable proportion of patients 2–3 years after referral for ankle radiography. BMI, chronic complaints and radiographic OA are prognostic factors for persistent complaints, but the additional predictive value of radiographic OA on top of clinical factors is negligible.

Prevalence and Associated Factors for Primary Osteoarthritis of the Scaphotrapeziotrapezoid, Radiocarpal, and Distal Radioulnar Joints in the Japanese General Elderly Population

The incidence and etiology of primary osteoarthritis (OA) of the scaphotrapeziotrapezoid joint (STTJ), radiocarpal joint (RCJ), and distal radioulnar joint (DRUJ) remains unknown. The purpose of this study was to evaluate the prevalence and factors associated with primary wrist OA in a cross-sectional study of a basic resident registry. A total of 1,297 residents between the ages of 50 and 89 years were randomly sampled from the registry of a Japanese town. A questionnaire was administered to all subjects, and each of them underwent radiographs of the bilateral hands, wrists, and elbows. STTJ, RCJ, and DRUJ radiographic osteoarthritis (ROA) were evaluated according to a previously described method. Associated factors for STTJ and DRUJ ROA were recorded. Associations between the incidence of ROA of the DRUJ, ulnar variance, and severity of elbow ROA were investigated. A total of 676 wrists (162 men and 176 women; mean age of 69.0 years) were investigated. The prevalence of STTJ, RCJ, and DRUJ ROA was 5.3%, 1.5%, and 21.2%, respectively. Factors associated with STTJ ROA were thumb carpometacarpal joint ROA, female sex, and increasing age. Factors associated with DRUJ ROA were elbow ROA, use of vibrating tools, increasing age, and positive ulnar variance. Prevalence of DRUJ ROA was 54.4% in wrists with severe-grade elbow ROA. Ulnar variance of the wrist in severe-grade elbow ROA was significantly larger than that in mild-grade or nonelbow ROA. The prevalence of ROA was highest in the DRUJ, followed by the STTJ, and lowest in the RCJ. The occurrence of ROA of the STTJ and DRUJ was affected by the presence of ROA of the adjacent joint. Primary DRUJ ROA occurs at a moderate frequency, similar to primary ROA of other extremity joints; however, primary STTJ and RCJ ROA is rare.

Association between hip pain and radiographic hip osteoarthritis in primary care: the CHECK cohort.

BackgroundThe diagnosis of hip osteoarthritis (OA) is often based on clinical symptoms, such as pain and stiffness, and radiographic features. However, the association between hip pain and hip radiographic OA (ROA) remains uncertain.AimTo examine the association between hip pain and hip ROA.Design and settingCross-sectional analysis of a Dutch cohort, the Cohort Hip and Cohort Knee (CHECK) study.MethodThe participants (aged 45–65 years) had all experienced hip and/or knee pain for which they had not had a prior consultation or were within 6 months of their first consultation with a GP. Using weight-bearing anteroposterior pelvis radiographs, definite and early-stage hip ROA were defined as Kellgren and Lawrence grade ≥2 and ≥1, respectively. Presence of ROA and pain was assessed in the hips of all participants. The association between hip pain and ROA was assessed using generalised estimating equations.ResultsThe prevalence of definite ROA was 11.0% (n = 218/1982 hips), with prevalence in painful and pain-free hips of 13.3% (n = 105/789) and 9.5% (n = 113/1193), respectively. Prevalence of early-stage hip ROA was 35.3% (n = 700/1982), with prevalence in painful and pain-free hips of 41.2% (n = 325/789) and 31.4% (n = 375/1193), respectively. Compared with pain-free hips, the odds ratio painful hips was 1.51 (95% confidence interval [CI] = 1.16 to 1.98) for definite ROA and 1.47 (95% CI = 1.24 to 1.75) for early-stage ROA.ConclusionHip pain was associated with definite and early-stage hip ROA, yet the overall ROA prevalence was modest and the prevalence among pain-free hips was substantial. Therefore, radiographs provided little assistance with help to identify patients with hip OA among patients who recently presented with hip or knee complaints.

A Cross-Sectional Study of Association between Plasma Selenium Levels and the Prevalence of Osteoarthritis: Data from the Xiangya Osteoarthritis Study.

Selenium plays an indispensable role in antioxidant and antiinflammation processes. Oxidative stress and inflammation have been hypothesized to be involved in the pathogenesis of cartilage degeneration. We sought to examine the association between plasma selenium levels and the prevalence of radiographic osteoarthritis (ROA). A population-based cross-sectional study. Individuals aged ≥ 50 years were retrieved from the Xiangya Osteoarthritis (XO) Study, a community-based study conducted among the residents of the rural areas of China. Plasma selenium concentration was measured by inductively coupled plasma-dynamic reaction cell-mass spectrometry. ROA was defined as Kellgren/Lawrence score ≥ 2 in at least one knee, hip or hand joint. The association between plasma selenium levels and ROA was evaluated by applying logistic and spline regression. A total of 1,032 subjects (women: 52.5%; mean age: 63.1 years; ROA prevalence: 45.4%) were included. Compared with the highest tertile, the odds ratios (ORs) for ROA were 1.24 (95% confidence interval [CI]: 0.91 to 1.68) and 1.77 (95% CI: 1.31 to 2.40) in the middle and lowest tertile of plasma selenium, respectively (P for trend<0.05). The results were not changed materially with adjustment of potential confounders. In addition, subjects who had lower plasma selenium levels exhibited a higher prevalence of ROA in a dose-response relationship manner (P=0.005). This study suggests that subjects with lower levels of plasma selenium exhibited a higher prevalence of ROA in a dose-response relationship manner. However, additional studies are still needed to verify the potential causal relationship.

RADIOGRAPHY OF OSTEOARTHRITIS AS AN ABNORMAL ANATOMICAL CHANGE IN GERIATRICS

The aim: A study was aimed to investigate the correlation between the prevalence of osteoarthritis and progression of age. Materials and methods: A study was conducted on two group of population; it increasing prevalence due to the demographic development of the society has major implications for individual and public healthcare with the increasing necessity for clinical imaging assessment in a high number of individuals. First group included 260 people their ages ranged from 65-70 year old. The second group included 270 elderly people their ages ranged from 71-80 year old. All people under study were imaged by radiography to diagnose different joints and bone affection which includes; a debilitating, degenerative disease of the articular cartilage and synovial fluid. The prevalence of radiographic osteoarthritis in different joints was record 31% in first group (65-70 year) as compare with 69.7% recorded to group two population (71-80 year). Results: From this study we can conclude that the progression of osteoarthritis after 71 years of age increased significantly. Therefore, the limitations of radiographs in osteoarthritis assessment could be overcome by these techniques. Conclusions: This article should provide an insight into the most important radiological features prevalence of osteoarthritis and their systematic visualization with different imaging approaches that can be used in clinical, radiologists and referring clinicians to better understand the evolution of symptomatic prevalence of osteoarthritis and the current or future clinical significance of the most common symptomatic and asymptomatic findings.

Prevalence of osteoarthritis and association between smoking patterns and osteoarthritis in China: a cross-sectional study

Abstract Objective The aims of this study were to estimate the prevalence of radiographic osteoarthritis (OA) and to assess the association between smoking patterns and OA prevalence in adults aged 50 years or older belonging to the Shanxi province of China. Methods A cross-sectional study in the rural regions of the Shanxi province was conducted among 2638 Chinese adults (aged ≥50 years). Demographic characteristics and behavioral information were collected through epidemiological surveys. All participants with joint pain underwent plain radiographic examination and were diagnosed by a professional orthopedist. Associations between smoking patterns and the prevalence of OA were assessed using binary logistic regression modeling. Results Among 2638 individuals (men, 50.3% and women, 49.7%; mean age, 61.5 years) included in the analysis, 49.8% had radiographic OA and 27.5% had knee OA. The prevalence of radiographic OA was higher in women than in men (P&lt;0.001). After adjusting for potential confounding factors, there was a nonsignificant correlation between smoking and OA prevalence in the multivariate model. Odds ratios (ORs) for all types of OA and knee OA were higher in active and passive smokers than in nonsmoking individuals after adjustments (OR 1.374; 95% confidence interval [CI] 1.049–1.802; OR 1.440; 95% CI 1.059–1.958, respectively). Conclusions This study showed that smoking may not be an independent risk factor for OA; however, there was a positive correlation between active and passive smoking and OA.

Study of metabolic syndrome frequency in elderly patients with knee osteoarthritis and its impact on the physical activity

Background Obesity is associated with an increased risk of osteoarthritis (OA). Metabolic syndrome (Met S) has been associated with a state of chronic low-grade inflammation and increased macrophages in the fat tissue. Hypertension and hyperglycaemia seem to be important BMI-independent factors of changes in osteoarthritic joints. Moreover, type 2 diabetes mellitus (DM) has been found to be an independent risk predictor for arthroplasty. Aim of the work To determine frequency and association of metabolic syndrome with knee osteoarthritis in elderly patients and its impact on the physical activity in elderly patients with knee osteoarthritis. Patients The study included patients aged above 65 years complaining of primary knee OA. The study included two groups: Gp A: Sixty patients >65 years with primary OA. Gp B: Forty apparently healthy elderly persons without knee OA as a control group. Exclusion Criteria: Patients with secondary knee OA. Methods All Patients were subjected to the following: Complete history taking, self-rated was measured by (SF-36), BMI, complete clinical musculoskeletal examination. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) 1st hr,fasting glucose level, 2 hr-post-prandial glucose level, triglycerides (TG), cholesterol, uric acid, high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c) and radiographic imaging of affected knee joints. Results According to (k/L) score of severity; grade 3 and grade 4 OA were significantly higher in patients with Met S than patients without Met S. The mean WOMAC pain subscale score was significantly higher in patients with OA and Met S than in patients with OA and without Met S with P value ( Conclusion Elevated systemic markers of inflammation are linked with components of Met S, with an increased prevalence of radiographic OA and joint symptoms.

Additional Value of Different Radiographic Views on the Identification of Early Radiographic Hip and Knee Osteoarthritis and Its Progression: A Cohort Study

To investigate the prevalence and progression of early radiographic osteoarthritis (OA) of the hip and knee on different radiographic views, to determine whether different radiographic views have additional value in detecting early hip and knee radiographic OA cases or progression. In the Cohort Hip and Cohort Knee (CHECK) study (n = 1,002), 5 different radiographs were obtained: an anteroposterior and faux profile view of the hips, and posteroanterior, mediolateral, and skyline views of the knees. The prevalence of radiographic OA was estimated based on each view separately and in combinations. We determined whether different radiographic views have additional value in detecting and determining the progression of radiographic OA cases, compared to standard projections. In the hip, we found 22.9% more cases when we combined both views. In the knee, we detected 79.7% more radiographic OA cases when we combined information from all 3 different radiographic views than when using only the posteroanterior view. Progression was seen in 33.1% more cases when using 2 hip radiographs, and in 65.1% more cases when using 3 knee radiographs. The use of different radiographic views increased the number of participants classified as having radiographic OA in an early OA cohort, both at baseline and at followup. The progression of early radiographic OA is demonstrated more frequently when multiple different radiographic views are used.

The effect of variation in interpretation of the La Trobe radiographic foot atlas on the prevalence of foot osteoarthritis in older women: the Chingford general population cohort

BackgroundThe prevalence of foot osteoarthritis (OA) is much less understood than hip, knee and hand OA. The foot is anatomically complex and different researchers have investigated different joints with lack of methodological standardisation across studies. The La Trobe Foot Atlas (LFA) is the first to address these issues in providing quantitative assessment of radiographic foot OA, but has not been tested externally. The aim of this study was to evaluate three different interpretive approaches to using the LFA for grading OA when scoring is difficult due to indistinct views of interosseous space and joint contour.MethodsFoot radiographs of all remaining participants (n = 218) assessed in the Chingford Women Study 23 year visit (mean (SD) for age: 75.5 years (5.1)) were scored using the LFA defined protocol (Technique 1). Two revised scoring strategies were applied to the radiographs in addition to the standard LFA analyses. Technique 2 categorised joints that were difficult to grade as ‘missing’. Technique 3 included joints that were difficult to grade as an over estimated score. Radiographic OA prevalence was defined for the foot both collectively and separately for individual joints.ResultsWhen radiographs were scored using the LFA (Technique 1), radiographic foot OA was present in 89.9%. For Technique 2 the presence of radiographic foot OA was 83.5% and for Technique 3 it was 97.2%. At the individual joint level, using Technique 1, the presence of radiographic foot OA was higher with a wider range (18.3–74.3%) than Technique 2 (17.9–46.3%) and lower with a wider range (18.3–74.3%) than Technique 3 (39.9–79.4%).ConclusionThe three different ways of interpreting the LFA scoring system when grading of individual joints is technically difficult and result in very different estimates of foot OA prevalence at both the individual joint and global foot level. Agreement on the best strategy is required to improve comparability between studies.

KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study

The prevalence of radiographic osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR) approaches 50%, yet the prevalence of significant knee pain is unknown. We applied three different models of Knee injury and Osteoarthritis Outcome Score (KOOS) thresholds for significant knee pain to an ACLR cohort to identify prevalence and risk factors. Multicenter Orthopaedic Outcomes Network (MOON) prospective cohort patients with a unilateral primary ACLR and normal contralateral knee were assessed at 2 and 6 years. Independent variables included patient demographics, validated Patient Reported Outcomes (PRO; Marx activity score, KOOS), and surgical characteristics. Models included: (1) KOOS criteria for a painful knee = quality of life subscale <87.5 and ≥2 of: KOOSpain <86.1, KOOSsymptoms <85.7, KOOSADL <86.8, or KOOSsports/rec <85.0; (2) KOOSpain subscale score ≤72 (≥2 standard deviations below population mean); (3) 10-point KOOSpain drop from 2 to 6 years. Proportional odds models (alpha ≤ 0.05) were used. 1761 patients of median age 23 years, median body mass index (BMI) 24.8 kg/m(2) and 56% male met inclusion, with 87% (1530/1761) and 86% (1506/1761) follow-up at 2 and 6 years, respectively. At 6 years, n = 592 (39%), n = 131 (9%) and n = 169 (12%) met criteria for models #1 through #3, respectively. The most consistent and strongest independent risk factor at both time-points was subsequent ipsilateral knee surgery. Low 2-year Marx activity score increased the odds of a painful knee at 6 years. Significant knee pain is prevalent after ACLR; with those who undergo subsequent ipsilateral surgery at greatest risk. The relationship between pain and structural OA warrants further study.

Prevalence of radiographic hip osteoarthritis is increased in high bone mass

SummaryObjectiveEpidemiological studies have shown an association between increased bone mineral density (BMD) and osteoarthritis (OA), but whether this represents cause or effect remains unclear. In this study, we used a novel approach to investigate this question, determining whether individuals with High Bone Mass (HBM) have a higher prevalence of radiographic hip OA compared with controls.DesignHBM cases came from the UK-based HBM study: HBM was defined by BMD Z-score. Unaffected relatives of index cases were recruited as family controls. Age-stratified random sampling was used to select further population controls from the Chingford and Hertfordshire cohort studies. Pelvic radiographs were pooled and assessed by a single observer blinded to case-control status. Analyses used logistic regression, adjusted for age, gender and body mass index (BMI).Results530 HBM hips in 272 cases (mean age 62.9 years, 74% female) and 1702 control hips in 863 controls (mean age 64.8 years, 84% female) were analysed. The prevalence of radiographic OA, defined as Croft score ≥3, was higher in cases compared with controls (20.0% vs 13.6%), with adjusted odds ratio (OR) [95% CI] 1.52 [1.09, 2.11], P = 0.013. Osteophytes (OR 2.12 [1.61, 2.79], P < 0.001) and subchondral sclerosis (OR 2.78 [1.49, 5.18], P = 0.001) were more prevalent in cases. However, no difference in the prevalence of joint space narrowing (JSN) was seen (OR 0.97 [0.72, 1.33], P = 0.869).ConclusionsAn increased prevalence of radiographic hip OA and osteophytosis was observed in HBM cases compared with controls, in keeping with a positive association between HBM and OA and suggesting that OA in HBM has a hypertrophic phenotype.

Quadriceps muscle strength and its relationship to radiographic knee osteoarthritis

Quadriceps muscle strength and its relationship to radiographic knee osteoarthritis

Quadriceps muscle strength and its relationship to radiographic knee osteoarthritis in Japanese elderly

BackgroundKnee osteoarthritis (OA) is a multifactorial disease and strongly affected by mechanical factors. The aims of the present study were to assess validity and reliability of a new muscle strength measuring device, the Quadriceps Training Machine (QTM) and evaluate the relationship between quadriceps strength measured by QTM and radiographic knee OA by epidemiological survey. MethodsThe isometric knee extension muscle strength of QTM was compared with BIODEX in 24 healthy adults. Then, the relationship between radiographic knee OA and quadriceps strength using QTM was investigated with 2,032 knees in 1,016 subjects by an epidemiological survey (Matsudai Knee Osteoarthritis Survey). ResultsSignificant correlation was observed between QTM and BIODEX (r=0.69, 0.82). In the Matsudai Knee Osteoarthritis Survey, the prevalence of radiographic OA (grade II or higher upon Kellgren–Lawrence classification) was: 13, 36.9, 67.8, and 86.5%, regarding women in their fifties, sixties, seventies, and eighties, respectively, and was 1.7, 13.4, 33.5, and 66.2% regarding men, respectively. Quadriceps muscle strength declined following 50years of age, and significant decline was observed in the their sixties and seventies. Quadriceps muscle strength of the OA group (grades II, III and IV) was significantly declined compared with that of the Non-OA group (grade-0 and I). Furthermore, the tendency of the muscle strength level to decline with the progression of knee OA grade was particularly observed between grade 0 and grade I in both men and women and between grade I and grade II in men. ConclusionThe relationship between radiographic knee OA and quadriceps strength was quantitatively evaluated by an epidemiological survey, and we found a correlation between knee OA and the decline in quadriceps strength. Furthermore, it was suggested that the decline in quadriceps muscle strength may be more strongly related to the incidence of knee OA than to its progression.

Immediate effects of unloader knee brace on knee pain and confidence in individuals with osteoarthritis after anterior cruciate ligament reconstruction

Immediate effects of unloader knee brace on knee pain and confidence in individuals with osteoarthritis after anterior cruciate ligament reconstruction

Genetic predisposition to the presence and 5-year clinical progression of hip osteoarthritis

Genetic factors are important in the aetiology of hip osteoarthritis (OA), but studies are limited by cross-sectional design and poor association with clinically important disease. Identifying cohorts with progressive OA will facilitate development of OA biomarkers. Using a middle-aged cohort with genetic predisposition to hip OA and a control group, we compared the prevalence of clinical and radiographic hip OA and incidence of progression over 5 years. 123 individuals (mean age 52 years) with a family history of total hip arthroplasty (THA) ('sibkids') were compared with 80 (mean age 54 years) controls. The prevalence of radiographic OA [scored according to Kellgren & Lawrence (K&L)], clinical features, and incidence of clinical progression over a 5-year period were compared. A multivariate logistic regression model was used to adjust for confounders. Sibkids had odds ratios (ORs) of 2.7 [95% confidence interval (CI) 1.1-6.3, P = 0.02] for hip OA (K&L grade ≥2), 3.4 (1.4-8.4, P = 0.008) for clinical signs, and 2.1 (0.8-5.8, P = 0.14) for signs and symptoms. Over 5 years, sibkids had ORs of 4.7 (1.7-13.2, P = 0.003) for the development of signs, and 3.2 (1.0-10.3, P = 0.047) for the development of signs and symptoms. Compared to a control group and after adjustment for confounders, individuals with genetic predisposition to end-stage hip OA have higher prevalence of OA, clinical features, and progression. In addition to structural degeneration, the inherited risk may include predisposition to pain. Genetically-loaded cohorts are useful to develop hip OA biomarkers, as they develop progressive disease at a young age.

Prevalence and involvement patterns of radiographic hand osteoarthritis in Japanese women: the Hizen–Oshima Study

The prevalence and pattern of joint involvement in radiographic hand osteoarthritis (OA) have been reported in Western populations, but similar data are lacking for Japanese. We examined this issue in 551 Japanese women aged > or = 40 years. Radiographs were obtained of both hands and graded according to the Kellgren-Lawrence (K-L) criteria. OA was defined as K-L grade 2 or higher. The prevalence of radiographic OA in the IP, MCP, and CMC joints was distributed similarly in both hands. The most frequent locations of radiographic OA were the distal IP joints of the index finger, the IP joint of the thumb, and the distal IP joints of the middle finger, in this order. The prevalence of radiographic OA in each joint group increased significantly with age, and that in Japanese women was lower in the thumb CMC joint and higher in the thumb IP joint compared to those in Caucasian women reported previously. The strongest predictor for the presence of radiographic OA in a particular joint was the disease status in the same joint of the opposite hand (OR = 18.5; 95% CI; 15.2-22.7), followed by the joints in the same row of the same hand (OR = 15.5; 95% CI, 11.9-20.1), and then by the joints in the same ray of the same hand (OR = 1.3; 95% CI, 1.0-1.6). Although the prevalence of hand OA is likely to show site-specific differences between Japanese and Caucasian women, our results indicate that both groups show similar involvement pattern symmetrically and in the same row of the same hand.

Prevalence of radiographic osteoarthritis—it all depends on your point of view

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. 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/metatarsophalangeal view; supine skyline; and supine lateral. 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 alone (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. 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.