Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, University of Melbourne, Victoria, Australia.
Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute of Medical Research, The University of Sydney, New South Wales, Australia.
Osteoarthritis Cartilage. 2016 Jul;24(7):1135-42. doi: 10.1016/j.joca.2016.01.986. Epub 2016 Feb 4.
To (1) document pain location in medial tibiofemoral osteoarthritis (OA) using the patient-administered Photographic Knee Pain Map (PKPM); (2) compare pain severity, nature and likelihood of neuropathic-like symptoms, physical dysfunction and presence of symptoms at other sites across the most common pain patterns.
Baseline data were analysed from 164 participants with medial tibiofemoral OA (TFJOA) participating in a randomised controlled trial (RCT). Participants completed the PKPM indicating all relevant pain zones of their most painful knee. Pain zones were collapsed into regions to determine patterns of pain. Symptoms were quantified using numeric rating scales (NRSs) of pain severity, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Intermittent and Constant Osteoarthritis Pain (ICOAP) and painDETECT questionnaires. Symptoms at other joints were categorised as present/absent.
The medial joint line (n = 123, 75%), patellar tendon (n = 62, 38%) and posterior knee (n = 61, 37%) were the most frequently reported pain zones. The most frequent patterns were diffuse (41%), isolated medial (16%), anterior-medial (12%) and medial-posterior (11%) pain. WOMAC and ICOAP scores were higher in the diffuse compared to anterior-medial patterns. Mean PainDETECT scores were higher with both diffuse and medial-posterior pain relative to anterior-medial pain.
Only 16% of the cohort indicated isolated medial knee pain, whilst a diffuse pain pattern was most common. People with diffuse knee pain reported more severe pain and physical dysfunction than those with anterior-medial pain. Prevalence of possible/likely neuropathic-like symptoms tended to be more frequent in diffuse and posterior-medial patterns compared to anterior-medial pain.
（1）使用患者自评的膝关节照相疼痛图（PKPM）记录内侧胫骨股骨骨关节炎（OA）的疼痛部位；（2）比较最常见疼痛模式中疼痛严重程度、性质和神经病理性症状可能性、身体功能障碍和其他部位症状的出现情况。
本分析基于参加一项随机对照试验（RCT）的 164 例内侧胫骨股骨 OA（TFJOA）患者的基线数据。患者使用 PKPM 图报告其最痛膝关节的所有相关疼痛区域。将疼痛区域合并为区域，以确定疼痛模式。使用疼痛严重程度的数字评定量表（NRS）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、间歇性和持续性骨关节炎疼痛（ICOAP）和疼痛 DETECT 问卷来量化症状。其他关节的症状分为存在/不存在。
内侧关节线（n=123，75%）、髌腱（n=62，38%）和膝关节后部（n=61，37%）是最常报告的疼痛区域。最常见的模式是弥漫性（41%）、孤立性内侧（16%）、前内侧（12%）和内侧-后（11%）疼痛。与前内侧模式相比，弥漫性疼痛模式的 WOMAC 和 ICOAP 评分更高。与前内侧疼痛相比，弥漫性和内侧-后疼痛的平均 PainDETECT 评分更高。
只有 16%的患者报告孤立性内侧膝关节疼痛，而弥漫性疼痛模式最为常见。膝关节弥漫性疼痛的患者报告的疼痛和身体功能障碍比前内侧疼痛更严重。与前内侧疼痛相比，弥漫性和内侧-后疼痛模式中可能/可能的神经病理性症状更为常见。
