Article Text

AB0834 A Proposal of Definition of Early Symptomatic Knee Osteoarthritis (Eskoa). Results from an International Consensus Promoted by the Italian Society of Rheumatology (Sir)
  1. A. Migliore1,
  2. C.A. Scirè2,
  3. L. Carmona3,
  4. E. Bizzi1,
  5. N. Damjanov4,
  6. R. Ionescu5,
  7. R. Rashkov6,
  8. D. Bablic-Nagic7,
  9. L. Collaku8,
  10. L. Denisov9,
  11. T. Barskova10,
  12. N. Martusevitch11,
  13. D. Diracoglu12,
  14. G. Herrero Beaumont13,
  15. X. Chevalier14,
  16. E. Maheu15,
  17. J. Branco16,
  18. R. Ramonda17,
  19. M. Scarpellini18,
  20. G. Bagnato19,
  21. M. Matucci Cerinic10
  1. 1Rheumatology, S.Pietro Fatebenefratelli Hospital, ROME
  2. 2Epidemiology Unit, Italian Society of Rheumatology, Milan, Italy
  3. 3Instituto de Salud Musculoesquelética, Madrid, Spain
  4. 4Rheumatology, Belgrade University School of Medicine, Belgrade, Serbia
  5. 5Rheumatology, Rheumatology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
  6. 6Rheumatology, Medical University Sofia, Sofia, Bulgaria
  7. 7Rheumatology and Rehabilitation, Zagreb Medical University, Zagreb, Croatia
  8. 8Internal Medicine, Medical University, Tirana, Albania
  9. 9Rheumatology, Russian Academy of Medical Science, Moscow, Russian Federation
  10. 10Rheumatology, University of Florence, Florence, Italy
  11. 11Internal diseases, Belarusian State University, Minsk, Belarus
  12. 12Rehabilitation, Istanbul University, Istanbul, Turkey
  13. 13Bone and joint research, Fudnacion Jimenez Diaz, Madrid, Spain
  14. 14Rheumatology, Henry Mondor Hospital, Creteil
  15. 15Rheumatology, Saint Antoine Hospital, Paris, France
  16. 16Rheumatology, Faculdade de Ciências Médicas, Lisbon, Portugal
  17. 17Rheumatology, University of Padova, Padova
  18. 18Rheumatology, Fornaroli Hospital, Magenta
  19. 19Rheumatology, University of Messina, Messina, Italy


Background In the literature, no validated definition of Early Symptomatic Knee OsteoArthritis (ESKOA) is available.

Objectives The Italian Society of Rheumatology (SIR) organized an international consensus to provide a proposal of a definition of ESKOA.

Methods A set of focus groups were held with expert clinicians, basic science researchers, and patients in order to identify signs, symptoms, and risk factors of ESKOA. In parallel, a systematic literature reviewed the existing definitions of ESKOA. An international panel of experts, convened by the SIR, identified a set of disease constructs; these constructs underwent two Delphi rounds for prioritisation and weighting of items to include in a definition of ESKOA. Finally, during a face to face meeting, the panel agreed on a final proposal for the definition of ESKOA.

Results The systematic review failed to identify any validated definition of ESKOA. The focus groups identified 46 items, among risk factors, signs, and symptoms, which could reflect a pre-radiographic stage of knee OA. After the first expert meeting, these items were reduced to 15, then two Delphi rounds, by the weighting of items, led to the ranking of the criteria. A further evaluation led to a final definition of an algorithm for the identification of patients affected by ESKOA (Figure 1).

Conclusions The diagnosis of ESKOA is today possible and opens a relevant problem that is the identification of the therapeutic regimens needed to slow down disease progression. The early identification of ESKOA patients might allow a better quality of life significantly reducing the social and health systems costs. A validation study aimed to confirm the appropriateness of these criteria is warranted.

Disclosure of Interest None declared

Statistics from

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.