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The discordance between clinical and radiographic knee osteoarthritis: A systematic search and summary of the literature
Open accessAbstract
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.
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Cited by
Raja, S. N., Carr, D. B., Cohen, M., Finnerup, N. B., Flor, H., Gibson, S., Keefe, F. J., Mogil, J. S., Ringkamp, M., Sluka, K. A., et al. (2020) · Pain · doi:10.1097/j.pain.0000000000001939 · Cited by 5,223
“An illustrative example is the discordance between reports of pain and the structural abnormalities visualized by imaging in patients with knee osteoarthritis.(6,30,36) The IASP has defined nociplastic pain as “pain that arises from altered nociception despite no clear evidence of actual or threatened tissue damage ca…”
BackgroundThe epidemiology and impact of pain in osteoarthritis
Neogi, T. (2013) · Osteoarthritis and Cartilage · doi:10.1016/j.joca.2013.03.018 · Cited by 1,730
Lee, Y. C., Nassikas, N. J., & Clauw, D. J. (2011) · Arthritis Research & Therapy · doi:10.1186/ar3306 · Cited by 377
An algorithmic approach to reducing unexplained pain disparities in underserved populations
Pierson, E., Cutler, D. M., Leskovec, J., Mullainathan, S., & Obermeyer, Z. (2021) · Nature Medicine · doi:10.1038/s41591-020-01192-7 · Cited by 268
Psychological profiles and pain characteristics of older adults with knee osteoarthritis
Cruz‐Almeida, Y., King, C. D., Goodin, B. R., Sibille, K. T., Glover, T. L., Riley, J. L., Sotolongo, A., Herbert, M. S., Schmidt, J., Fessler, B. J., et al. (2013) · Arthritis Care & Research · doi:10.1002/acr.22070 · Cited by 157
Meurot, C., Martin, C., Sudre, L., Breton, J., Bougault, C., Rattenbach, R., Bismuth, K., Jacques, C., & Berenbaum, F. (2022) · Scientific Reports · doi:10.1038/s41598-022-05323-7 · Cited by 160
Cottrell, E., Roddy, E., & Foster, N. E. (2010) · BMC Family Practice · doi:10.1186/1471-2296-11-4 · Cited by 90
“to the discordance between pain and OA-related radiographic changes [21].”
Brown, C. A., El‐Deredy, W., & Jones, A. K. P. (2014) · European Journal of Neuroscience · doi:10.1111/ejn.12420 · Cited by 71
Advancing osteoarthritis research: The role of AI in clinical, imaging and omics fields
Ou, J., Zhang, J., Alswadeh, M., Zhu, Z., Tang, J., Sang, H., & Lu, K. (2025) · Bone Research · doi:10.1038/s41413-025-00423-2 · Cited by 61
Schulze, C., Schunck, M., Zdzieblik, D., & Oesser, S. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21060687 · Cited by 10
Metadata
- Authors
- Bedson, J., & Croft, P. R.
- Venue
- BMC Musculoskeletal Disorders
- Published
- 2008-09-02
- Volume
- 9
- Issue
- 1
- Pages
- 116-116
- ISSN
- 1471-2474 (ISSN-L)
- OpenAlex
- W2092980618
- Cited by
- 951
- References
- 0
- FWCI
- 13.61
- Type
- journal article
- Language
- en
- Open access
- gold
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