Pain presentation and diagnostic performance can help identify Patellofemoral Joint Osteoarthritis

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Pain presentation and diagnostic performance can help identify Patellofemoral Joint Osteoarthritis

A recent study published in Arthritis Care & Research in 2017, has revealed that a typical clinical examination measures and knee pain patterns may indicate underlying patellofemoral (PF) pathology.

Patellofemoral osteoarthritis (OA) refers to arthritis of patella which means underneath the kneecap. This study is based on differentiating PF osteoarthritis from tibiofemoral (TF) OA by estimating the potential of the diagnostic performance of a comprehensive set of tests and measures for distinction.

The study method relied on the clinical assessment of the knee study which referred to the study of knee pain in the general population. Firstly, the presence of PF crepitus and pain with regard to PF compression were assessed, and then Anterior knee pain (AKP) was assessed from a knee pain map. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to determine the pain associated with stairs and walking on level ground. The compartment(s) of the knee affected by OA was interpreted by radiography and classified as: no OA, isolated/predominant PF OA and isolated/predominant TF OA. Knees suffering from mixed OA and knees with more severe PF OA were incorporated in the isolated/predominant PF group (the same was done for TF OA). The sensitivity (Sn), specificity (Sp), positive and negative predictive values (PPV and NPV) and positive likelihood ratio (LR+) for each test was determined and estimated individually, and the combination of these measures was employed in identifying knees with PF OA from knees with TF OA or no OA.

The results of the study showed that out of 745 knees included in the study, no measure had high Sn and Sp values. Pain associated with stairs had the greatest Sn (90%) but poor Sp (15%). Greatest Sp (96%), PPV (53%) and LR+ (1.8) but poor Sn (7%) was found in the combination of definite crepitus with no pain on walking.

It was concluded that typical clinical examination measures and knee pain patterns commonly thought to represent underlying PF pathology, but they were unable to discriminate knees with PF OA from knees without OA or TF OA.

Source:

Arthritis Care & Research

Link to the source:

http://onlinelibrary.wiley.com/doi/10.1002/acr.23238/ful

The original title of the article:

Diagnostic Performance of Clinical Examination Measures and Pain Presentation to Identify Patellofemoral Joint Osteoarthritis.

Authors:

J.J. Stefanik MSPT et al.

SearchTags: 
Pain presentation, Diagnostic performance, Patellofemoral Joint Osteoarthritis
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