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AB0951 Can a clinician predict clinical presentation of osteoarthritis knee by knee radiology?
  1. A. Singh,
  2. R.N. Srivastava
  1. Orthopaedics, C. S. M. Medical University, Lucknow, India, Lucknow, India

Abstract

Background Discordance between clinical and radiological profiles in knee osteoarthritis has been reported.

Objectives This study essentially analyzed radiological features of osteoarthritis knee in order to seek an association between clinical and radiographic features

Methods The prospective study was conducted on 120 patients with osteoarthritis knee enrolled (as per inclusion and exclusion criterion) on OPD basis during the year 2007 -2008. After getting informed consent, demographic data were noted and all were clinically evaluated. Kellgren Lawrence staging of the X-rays (AP and Lateral views – weight bearing) was done. MRI was done of affordable patients. Severity of the disease was analyzed according to – A] Visual Analogue Score B] WOMAC Index and C] Lequesne Index. MRI were analyzed under the following headings: Marginal osteophytes, subchondral cyst, subchondral sclerosis, subchondral trabecular BME, cartilage defect, joint effusion, bakers/synovial cyst, synovitis, ligament and meniscal abnormalities.

Results Majority of subjects in our study were found to be between 51 – 60 years – 51 cases (42.50%) of age. Females were more commonly affected in all age groups. In our study maximum number of patients were in BMI range of >25 – 71 cases(59.17%). Maximum patients presented with a VAS score of 6- 95 cases (79.17%) with females predominating males. In each VAS score females predominated males. Maximum number of patients presented with a WOMAC score of 8 - 42 cases (35.00%). At all WOMAC scores mentioned, usually females outnumber males except; at scores 7 and 10 where males outnumbered females. Maximum number of patients presented with a lequesne score of 2 - 91 cases (75.83%) with females outnumbering males. When individuals knees on considered we found percentage of right knee involvement more in females in terms of joint space, articular congruity, juxtra articular osteopenia and subchondral sclerosis and percentage of left knee involvement more in males in terms of subchondral cysts, loose bodies and extra-articular calcificationAge has thus got a significant association with KL grade (“p” value =0.008). There was found to be a significant association between stage of disease and occurrence of swelling (”p”=0.016). A correlation was made between Sex, Occupation and Socioeconomic status of patients with KL Grade. Intergroup analysis showed insignificant association between crepitus and association of disease. There is a significant association between KL grade and womac pain score of patient (“p”=0.003). There was statistically significant association seen between radiological presence of subchondral cyst and severity of disease (“p”= Left = 0.001, Right = 0.000). There was a significant association seen between presence of juxtra-articular osteopenia and severity of disease (“p” = Left – 0.001, Right – 0.017). No statistically significant association was seen between presence of loose bodies with KL grade (“p”=0.258). In right knee the relationship between extra-articular calcification and severity of disease was significant (“p”=0.015). MRI features related with radiology i.e. no additional significant information generated by MRI over plain radiology.

Conclusions there is a significant correlation of radiological (plain radiograph) features of knee osteoarthritis with its clinical manifestation

Disclosure of Interest None Declared

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