Article

OBJECTIVE: To determine the prevalence of generalized osteoarthritis in patients
with knee osteoarthritis. METHODS: Patients with knee osteoarthritis were
recruited for a therapeutic trial via press announcement and selected based on
American College of Rheumatology radioclinical criteria for femorotibial
arthritis. Patients were asked to bring all their radiographs to the study
visits, which included a physical examination. Each patient had an inclusion
visit and a second visit 1 month later. The study physicians used a standardized
chart to indicate clinical and radiographic evidence of osteoarthritis in each
patient. At the hands and feet, the presence of clinical criteria was sufficient
for the diagnosis of osteoarthritis. The shoulders and elbows were not assessed.
Three criteria sets for generalized osteoarthritis were evaluated: Kellgren and
Moore criteria (Heberden's nodes or interphalangeal osteoarthritis), ACR criteria
(osteoarthritis of the spine and at least two other joints), and Dougados
criteria (bilateral finger osteoarthritis or osteoarthritis of the spine and both
knees). RESULTS: We included 302 patients for whom the side affected with knee
osteoarthritis was known. Mean symptom duration was 5.9+/-5.7 years, mean number
of painful flares was 10.1+/-9.4, mean number of joints with osteoarthritis was
2.6+/-1.8, and mean body mass index was 29.5+/-5.3kg/m(2). A family history of
osteoarthritis was noted in 154 (51%) patients and spinal osteoarthritis in 148
(49%) patients. Kellgren-Moore criteria for interphalangeal osteoarthritis were
met in 42 (13.9%) patients, ACR criteria by 124 (41%) patients, and Dougados
criteria by 127 (42%) patients. In all, 156 (52%) patients met at least one of
the three definitions of generalized osteoarthritis. CONCLUSION: More than half
the patients included in a therapeutic trial in knee osteoarthritis had
generalized osteoarthritis with maximum symptoms at the knee at baseline. Some
patients with osteoarthritis in multiple joints met none of the three criteria
sets for generalized osteoarthritis. Further studies are needed to assess the
sensitivity and specificity of current criteria sets and, if needed, to identify
new criteria.
CI - Copyright (c) 2009 Societe francaise de rhumatologie. Published by Elsevier SAS.
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Langue : ANGLAIS