Pereira Silva Moreira Vanessa Martins, Delfino Barboza Saulo, Borges Oliveira Juliana, Moura Pereira Janser, Carlos Dionisio Valdeci
Universidade Federal de Uberlândia (UFU), Faculdade de Medicina, Programa de Mestrado em Ciências da Saúde, Uberlândia, MG, Brazil.
Universidade Federal de Uberlândia (UFU), Faculdade de Medicina, Programa de Mestrado em Ciências da Saúde, Uberlândia, MG, Brazil.
Rev Bras Reumatol Engl Ed. 2017 Jan-Feb;57(1):37-44. doi: 10.1016/j.rbre.2016.03.014. Epub 2016 Apr 13.
Secondary hyperalgesia in individuals with less severe levels of knee osteoarthritis remains unclear. The objective of this study was to measure the pressure pain threshold of individuals with mild or moderate knee osteoarthritis and compare with no osteoarthritis.
Ten healthy controls and 30 individuals with mild or moderate knee osteoarthritis divided into two groups (unilateral and bilateral involvement) were included. Dermatomes in lumbar levels (L1, L2, L3, L4 and L5) and sacral level (S1 and S2), myotomes (vastus medialis, vastus lateralis, rectus femoris, adductor longus, tibialis anterior, peroneus longus, iliacus, quadratus lumborum, and popliteus muscles), and sclerotomes in lumbar levels (L1-L2, L2-L3, L3-L4, L4-L5 supraspinous ligaments), over the L5-S1 and S1-S2 sacral areas, pes anserinus bursae, and at the patellar tendon pressure pain threshold were assessed and compared between individuals with and without knee osteoarthritis.
Knee osteoarthritis groups (unilateral and bilateral) reported lower pressure pain threshold compared to the control group in most areas (dermatomes, myotomes, and sclerotomes). There were no between group differences in the supra-spinous ligaments and over the L5-S1 and S1-S2 sacral areas of the sclerotomes. No difference was seen between knee osteoarthritis.
These findings suggest that individuals with mild to moderate knee osteoarthritis had primary and secondary hyperalgesia, independent of unilateral or bilateral involvement. These results suggest that the pain have to be an assertive focus in the clinical practice, independent of the level of severity or involvement of knee osteoarthritis.
膝骨关节炎程度较轻的个体的继发性痛觉过敏仍不明确。本研究的目的是测量轻度或中度膝骨关节炎个体的压力痛阈，并与无骨关节炎的个体进行比较。
纳入10名健康对照者和30名轻度或中度膝骨关节炎患者，后者分为两组（单侧和双侧受累）。评估并比较了膝骨关节炎患者和非膝骨关节炎患者在腰段（L1、L2、L3、L4和L5）和骶段（S1和S2）的皮节、肌节（股内侧肌、股外侧肌、股直肌、长收肌、胫骨前肌、腓骨长肌、髂肌、腰方肌和腘肌）以及腰段（L1-L2、L2-L3、L3-L4、L4-L5棘上韧带）、L5-S1和S1-S2骶区、鹅足囊和髌腱处的压力痛阈。
与对照组相比，膝骨关节炎组（单侧和双侧）在大多数区域（皮节、肌节和骨节）的压力痛阈较低。在棘上韧带以及骨节的L5-S1和S1-S2骶区，两组之间没有差异。膝骨关节炎患者之间没有差异。
这些发现表明，轻度至中度膝骨关节炎患者存在原发性和继发性痛觉过敏，与单侧或双侧受累无关。这些结果表明，在临床实践中，疼痛必须作为一个明确的重点，而与膝骨关节炎的严重程度或受累情况无关。
