Ann Rheum Dis 1997;56:493-496 ( August )

Concise reports

Radiographic osteoarthritis of the knee classified by the Ahlbäck and Kellgren & Lawrence systems for the tibiofemoral joint in people aged 35-54 years with chronic knee pain Ingemar F Petersson,^a Torsten Boegård,^b Tore Saxne,^c Alan J Silman,^d Björn Svensson^e

^a Spenshult's Hospital for Rheumatic Diseases, Halmstad, Sweden , ^b Department of Diagnostic Radiology, Helsingborg County Hospital, Sweden , ^c Department of Rheumatology Lund University, Lund, Sweden , ^d ARC Epidemiology Research Unit, University of Manchester, Manchester , ^e Department of Rheumatology, Helsingborg County Hospital, Sweden

Correspondence to: Dr I Petersson, Spenshult's Hospital for Rheumatic Diseases, S-313 92 Oskarström, Sweden.

Accepted for publication 2 June 1997

OBJECTIVESTo determine the prevalence of tibiofemoral radiographic knee osteoarthritis (OA) in people aged 35-54 years associated with chronic (> 3 months) knee pain using two different radiographic grading systems.
METHODSPopulation based postal survey in a random sample of inhabitants in a district in southern Sweden followed by clinical examination and plain posteroanterior, weight bearing radiographical examination. The Ahlbäck criteria (focusing on joint space narrowing) and the Kell- gren & Lawrence classification for knee OA were used for diagnosing tibiofemoral OA.
RESULTSA questionnaire was sent to 2000 randomly selected people aged 35-54 years. The response rate was 92.6%. Fifteen per cent of these people reported chronic knee pain. This group (n=279) was offered a clinical and radiographic examination of the knee joint and 204 persons agreed to participate. According to the Kellgren & Lawrence classification 28 subjects had OA of the knee grade 2 or more and 16 grade 3 or more. Radiographically detected OA of the knee according to Ahlbäck was found in 20 cases. The minimum prevalence of radiological tibiofemoral knee OA with knee pain was thus 1.5% for Kellgren & Lawrence grade 2 or more, 0.9% for grade 3 or more, and 1.1% according to the Ahlbäck classification. The agreement between the Kellgren & Lawrence grades 2-3 versus Ahlbäck grade I as well as grade 3-4 versus Ahlbäck grade I-II was good ( 0.76 and 0.78 respectively).
CONCLUSIONThe prevalence of radiographic tibiofemoral OA combined with chronic knee pain in people aged 35-54 years was around 1% as estimated by either the Kellgren & Lawrence or the Ahlbäck classifications systems. Prospective follow up of this cohort should elucidate the significance of knee pain as a sign of developing OA.

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© 1997 by Annals of the Rheumatic Diseases
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