Skip to main content
PMC home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1993 Jul;52(7):520–526. doi: 10.1136/ard.52.7.520

Radiographic patterns and associations of osteoarthritis of the knee in patients referred to hospital.

J Ledingham 1, M Regan 1, A Jones 1, M Doherty 1
PMCID: PMC1005091  PMID: 8346979

Abstract

OBJECTIVES--To investigate differing patterns and associations of osteoarthritis of the knee in patients referred to hospital. METHODS--Two hundred and fifty two consecutive patients (161 women, 91 men; mean age 70 years, range 34-91 years) referred to hospital with osteoarthritis of the knee underwent clinical, radiographic, and synovial fluid screening. RESULTS--Radiographic changes of osteoarthritis of the knee (definite narrowing with or without osteoarthritic features) were bilateral in 85% of patients. Of 470 knees affected, 277 (59%) were affected in two compartments and 28 (6%) in three compartments. Unilateral and isolated medial tibiofemoral osteoarthritis were more common in men. Calcium pyrophosphate crystal deposition was common (synovial fluid identification in 132 (28%) knees; knee chondrocalcinosis in 76 (30%) patients) and associated with disability, bilateral, multicompartmental and severe radiographic osteoarthritis, marked osteophytosis, attrition, and cysts. Multiple clinical nodes (58 (23%) patients) and radiographic polyarticular interphalangeal osteoarthritis (66 (26%) patients) were associated with a higher frequency of inactivity pain, disability, multicompartmental and severe radiographic change. Forestier's disease predominated in men but showed no other associations. CONCLUSIONS--In a group of patients referred to hospital osteoarthritis of the knee is usually bilateral and affects more than one compartment. Severe and multicompartmental radiographic changes are associated with calcium pyrophosphate crystal deposition, nodal change, and polyarticular interphalangeal osteoarthritis.

Full text

PDF
526

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bohan A. The private practice of rheumatology. The first 1,000 patients. Arthritis Rheum. 1981 Oct;24(10):1304–1307. doi: 10.1002/art.1780241011. [DOI] [PubMed] [Google Scholar]
  2. Cushnaghan J., Dieppe P. Study of 500 patients with limb joint osteoarthritis. I. Analysis by age, sex, and distribution of symptomatic joint sites. Ann Rheum Dis. 1991 Jan;50(1):8–13. doi: 10.1136/ard.50.1.8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Davis M. A., Ettinger W. H., Neuhaus J. M., Cho S. A., Hauck W. W. The association of knee injury and obesity with unilateral and bilateral osteoarthritis of the knee. Am J Epidemiol. 1989 Aug;130(2):278–288. doi: 10.1093/oxfordjournals.aje.a115334. [DOI] [PubMed] [Google Scholar]
  4. Dieppe P. A., Doherty M., Macfarlane D. G., Hutton C. W., Bradfield J. W., Watt I. Apatite associated destructive arthritis. Br J Rheumatol. 1984 May;23(2):84–91. doi: 10.1093/rheumatology/23.2.84. [DOI] [PubMed] [Google Scholar]
  5. Doherty M., Dieppe P. Clinical aspects of calcium pyrophosphate dihydrate crystal deposition. Rheum Dis Clin North Am. 1988 Aug;14(2):395–414. [PubMed] [Google Scholar]
  6. Doherty M., Watt I., Dieppe P. Influence of primary generalised osteoarthritis on development of secondary osteoarthritis. Lancet. 1983 Jul 2;2(8340):8–11. doi: 10.1016/s0140-6736(83)90003-x. [DOI] [PubMed] [Google Scholar]
  7. Felson D. T. The epidemiology of knee osteoarthritis: results from the Framingham Osteoarthritis Study. Semin Arthritis Rheum. 1990 Dec;20(3 Suppl 1):42–50. doi: 10.1016/0049-0172(90)90046-i. [DOI] [PubMed] [Google Scholar]
  8. Forman M. D., Malamet R., Kaplan D. A survey of osteoarthritis of the knee in the elderly. J Rheumatol. 1983 Apr;10(2):282–287. [PubMed] [Google Scholar]
  9. Gibson P. H., Goodfellow J. W. Stress radiography in degenerative arthritis of the knee. J Bone Joint Surg Br. 1986 Aug;68(4):608–609. doi: 10.1302/0301-620X.68B4.3733839. [DOI] [PubMed] [Google Scholar]
  10. Gordon T. P., Smith M., Ebert B., McCredie M., Brooks P. M. Articular chondrocalcinosis in a hospital population: an Australian experience. Aust N Z J Med. 1984 Oct;14(5):655–659. doi: 10.1111/j.1445-5994.1984.tb05019.x. [DOI] [PubMed] [Google Scholar]
  11. Halverson P. B., McCarty D. J. Patterns of radiographic abnormalities associated with basic calcium phosphate and calcium pyrophosphate dihydrate crystal deposition in the knee. Ann Rheum Dis. 1986 Jul;45(7):603–605. doi: 10.1136/ard.45.7.603. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Hernborg J. S., Nilsson B. E. The natural course of untreated osteoarthritis of the knee. Clin Orthop Relat Res. 1977 Mar-Apr;(123):130–137. [PubMed] [Google Scholar]
  13. Hopkinson N. D., Powell R. J., Doherty M. Autoantibodies, immunoglobulins and Gm allotypes in nodal generalized osteoarthritis. Br J Rheumatol. 1992 Sep;31(9):605–608. doi: 10.1093/rheumatology/31.9.605. [DOI] [PubMed] [Google Scholar]
  14. KELLGREN J. H., LAWRENCE J. S. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957 Dec;16(4):494–502. doi: 10.1136/ard.16.4.494. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Kannus P., Järvinen M., Kontiala H., Bergius L., Hyssy E., Salminen E., Tuomi A., Unkila T., Valtanen I. Occurrence of symptomatic knee osteoarthrosis in rural Finland: a prospective follow up study. Ann Rheum Dis. 1987 Nov;46(11):804–808. doi: 10.1136/ard.46.11.804. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Leach R. E., Gregg T., Siber F. J. Weight-bearing radiography in osteoarthritis of the knee. Radiology. 1970 Nov;97(2):265–268. doi: 10.1148/97.2.265. [DOI] [PubMed] [Google Scholar]
  17. Ledingham J., Dawson S., Preston B., Milligan G., Doherty M. Radiographic patterns and associations of osteoarthritis of the hip. Ann Rheum Dis. 1992 Oct;51(10):1111–1116. doi: 10.1136/ard.51.10.1111. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Marks J. S., Stewart I. M., Hardinge K. Primary osteoathrosis of the hip and Heberden's nodes. Ann Rheum Dis. 1979 Apr;38(2):107–111. doi: 10.1136/ard.38.2.107. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. McAlindon T. E., Snow S., Cooper C., Dieppe P. A. Radiographic patterns of osteoarthritis of the knee joint in the community: the importance of the patellofemoral joint. Ann Rheum Dis. 1992 Jul;51(7):844–849. doi: 10.1136/ard.51.7.844. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. McAlindon T., Dieppe P. Osteoarthritis: definitions and criteria. Ann Rheum Dis. 1989 Jul;48(7):531–532. doi: 10.1136/ard.48.7.531. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. McGoldrick F., O'Brien T. M. Osteoarthritis of the hip and Heberden's nodes. Ann Rheum Dis. 1989 Jan;48(1):53–55. doi: 10.1136/ard.48.1.53. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Pattrick M., Hamilton E., Wilson R., Austin S., Doherty M. Association of radiographic changes of osteoarthritis, symptoms, and synovial fluid particles in 300 knees. Ann Rheum Dis. 1993 Feb;52(2):97–103. doi: 10.1136/ard.52.2.97. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Peyron J. G. Epidemiologic and etiologic approach of osteoarthritis. Semin Arthritis Rheum. 1979 May;8(4):288–306. doi: 10.1016/0049-0172(79)90006-4. [DOI] [PubMed] [Google Scholar]
  24. Puchtler H., Meloan S. N., Terry M. S. On the history and mechanism of alizarin and alizarin red S stains for calcium. J Histochem Cytochem. 1969 Feb;17(2):110–124. doi: 10.1177/17.2.110. [DOI] [PubMed] [Google Scholar]
  25. Resnick D., Niwayama G., Goergen T. G., Utsinger P. D., Shapiro R. F., Haselwood D. H., Wiesner K. B. Clinical, radiographic and pathologic abnormalities in calcium pyrophosphate dihydrate deposition disease (CPPD): pseudogout. Radiology. 1977 Jan;122(1):1–15. doi: 10.1148/122.1.1. [DOI] [PubMed] [Google Scholar]
  26. Schouten J. S., van den Ouweland F. A., Valkenburg H. A. A 12 year follow up study in the general population on prognostic factors of cartilage loss in osteoarthritis of the knee. Ann Rheum Dis. 1992 Aug;51(8):932–937. doi: 10.1136/ard.51.8.932. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Solomon L. Patterns of osteoarthritis of the hip. J Bone Joint Surg Br. 1976 May;58(2):176–183. doi: 10.1302/0301-620X.58B2.932079. [DOI] [PubMed] [Google Scholar]
  28. Spector T. D. The fat on the joint: osteoarthritis and obesity. J Rheumatol. 1990 Mar;17(3):283–284. [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES