Abstract
OBJECTIVE: To compare three questions on knee pain with respect to determined prevalence and associations with disability and structural change. METHODS: Postal survey to 4057 men and women aged 40-79 years. Knee pain was defined by three questions: (A) "Have you ever had pain in or around the knee on most days for at least a month? If so, have you experienced any pain during the last year?" (B) "Have you had pain within the last year in or around the knee that occurred on most days for at least a month?" (C) "Have you had knee pain on most days of the last month?" [American College of Rheumatology (ACR) criteria for knee osteoarthritis]. Disability was assessed with the SF-36 health status questionnaire. Radiographs (AP weight bearing and skyline) were obtained on a proportion (n = 459) and graded for maximum osteophyte in any compartment. RESULTS: Prevalence of knee pain for questions A, B, and C were 28.3%, 25.3%, and 19.3% respectively. Highest rates of disability were observed for question C (71.3% compared with 60.9% for question A). There was no major difference between questions in terms of percentage with > or = grade 1 osteophyte or > or = grade 2 osteophyte. Sensitivity and specificity of each question for > or = grade 1 osteophyte did vary, with question A being most sensitive but least specific (58.7% and 59.1%) and question C most specific (72.7%) but least sensitive (45.4%). CONCLUSIONS: Estimates of knee pain and disability are influenced by even minor changes in question content. The ACR criteria question may be a better predictor of disability but is relatively insensitive for use in the community.
Full text
PDF


Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Altman R., Asch E., Bloch D., Bole G., Borenstein D., Brandt K., Christy W., Cooke T. D., Greenwald R., Hochberg M. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986 Aug;29(8):1039–1049. doi: 10.1002/art.1780290816. [DOI] [PubMed] [Google Scholar]
- Anderson J. J., Felson D. T. Factors associated with osteoarthritis of the knee in the first national Health and Nutrition Examination Survey (HANES I). Evidence for an association with overweight, race, and physical demands of work. Am J Epidemiol. 1988 Jul;128(1):179–189. doi: 10.1093/oxfordjournals.aje.a114939. [DOI] [PubMed] [Google Scholar]
- Brazier J. E., Harper R., Jones N. M., O'Cathain A., Thomas K. J., Usherwood T., Westlake L. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992 Jul 18;305(6846):160–164. doi: 10.1136/bmj.305.6846.160. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cicuttini F. M., Baker J., Hart D. J., Spector T. D. Choosing the best method for radiological assessment of patellofemoral osteoarthritis. Ann Rheum Dis. 1996 Feb;55(2):134–136. doi: 10.1136/ard.55.2.134. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Felson D. T., Naimark A., Anderson J., Kazis L., Castelli W., Meenan R. F. The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum. 1987 Aug;30(8):914–918. doi: 10.1002/art.1780300811. [DOI] [PubMed] [Google Scholar]
- Hadler N. M. Knee pain is the malady--not osteoarthritis. Ann Intern Med. 1992 Apr 1;116(7):598–599. doi: 10.7326/0003-4819-116-7-598. [DOI] [PubMed] [Google Scholar]
- Jones A. C., Ledingham J., McAlindon T., Regan M., Hart D., MacMillan P. J., Doherty M. Radiographic assessment of patellofemoral osteoarthritis. Ann Rheum Dis. 1993 Sep;52(9):655–658. doi: 10.1136/ard.52.9.655. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lawrence J. S., Bremner J. M., Bier F. Osteo-arthrosis. Prevalence in the population and relationship between symptoms and x-ray changes. Ann Rheum Dis. 1966 Jan;25(1):1–24. [PMC free article] [PubMed] [Google Scholar]
- McAlindon T. E., Cooper C., Kirwan J. R., Dieppe P. A. Knee pain and disability in the community. Br J Rheumatol. 1992 Mar;31(3):189–192. doi: 10.1093/rheumatology/31.3.189. [DOI] [PubMed] [Google Scholar]