Symptoms and radiographic osteoarthritis: not as discordant as they are made out to be?

R Duncan, G Peat, E Thomas, E Hay, I McCall and P Croft

The aim of this study was to investigate this issue more closely by studying the detailed nature of pain and disability, and how this relates to radiographic osteoarthritis.  The results showed that radiographic osteoarthritis was more common in those with a longer history and more persistent symptoms. A strong trend was found of radiographic osteoarthritis being more strongly associated with higher WOMAC scores for pain severity, stiffness and disability. Those individual WOMAC items for pain and disability pertaining to weight-bearing mobility were the most strongly associated with radiographic osteoarthritis. Combining pain persistence and global severity, persistent severe pain was associated with a significant increase in the occurrence of radiographic osteoarthritis.  The authors conclude that a consistent association was found between severity of pain, stiffness and physical function and the presence of radiographic osteoarthritis. This study highlights the potential contribution of underlying joint disease to the degree of pain and disability.

Annals of the Rheumatic Diseases 2007;66:86-91

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