Factors associated with knee pain at early stages of osteoarthritis
Objective: To investigate key risk factors associated with knee pain in early-stage osteoarthritis (OA).Material and methods. The study included 109 women aged 35–75 years with knee pain lasting no more than one year and minimal radiographic changes (Kellgren–Lawrence grades 0–II). For each patient...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | Russian |
| Published: |
IMA-PRESS LLC
2025-06-01
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| Series: | Современная ревматология |
| Subjects: | |
| Online Access: | https://mrj.ima-press.net/mrj/article/view/1775 |
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| Summary: | Objective: To investigate key risk factors associated with knee pain in early-stage osteoarthritis (OA).Material and methods. The study included 109 women aged 35–75 years with knee pain lasting no more than one year and minimal radiographic changes (Kellgren–Lawrence grades 0–II). For each patient we filled in a personalized case form including anthropometric data, medical history, physical examination findings, pain and health status assessments using visual analog scale (VAS), and questionnaires (WOMAC, KOOS, DN4), along with information on comorbidities. All participants underwent standard knee radiography, ultrasound examination, and laboratory testing.Results and discussion. One in six patients (15%) reported moderate or severe knee pain (≥40 mm on VAS). Patients with more intense pain were older than those with VAS <40 mm (median age 52.5 [42; 62.5] vs. 44 [38; 52] years; p=0.02) and had a higher body mass index (28 [25; 31.6] vs. 24 [21; 28] kg/m2; p=0.04). Statistically significant differences were also observed in OA severity: the high-pain group had higher WOMAC and all its components’ scores (median 1245 [872; 1510] vs. 248 [90; 410] mm; p<0.001), lower self-rated health status (60 [47; 80] vs. 29.5 [10; 50] mm; p<0.001), lower KOOS total scores and its components’ scores (44 [37; 67] vs. 79 [63; 88] %; p<0.001), and more frequent detection of synovitis on examination (50% vs. 19.3%; p<0.001) and in the past history (75% vs. 31.1%; p=0.008). Flexion restriction (50% vs. 19.3%; p=0.01), presence of osteophytes on ultrasound (50% vs. 10.75%; p<0.001), metabolic syndrome (56.25% vs. 25.8%; p=0.03), and postmenopausal status (68.75% vs. 35.48%; p=0.01) were also more frequent.A discriminant model was developed to predict the risk of pain ≥40 mm on VAS, incorporating WOMAC functional limitations, presence of metabolic syndrome, ultrasound-detected osteophytes, and clinically significant synovitis. The model achieved an accuracy of 90.8%. Predictive performance was confirmed by ROC analysis (AUC=0.898, 95% CI 0.794–1.002), indicating high prognostic accuracy.Conclusion. Severe knee pain at early stages of OA is associated with functional impairment according to WOMAC, clinical synovitis, ultrasounddetected osteophytes, and metabolic syndrome. These risk factors and the developed predictive model may be useful for planning individualized preventive and therapeutic strategies in OA patients. |
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| ISSN: | 1996-7012 2310-158X |