Osteoarthritis: Clinical and Radiological Correlation.

BACKGROUND

Osteoarthritis (OA) is a slowly progressive degenerative joint disease, characterized by pain and functional disability. Various outcome measures for radiographic and clinical OA are described in studies. A limitation of radiographic evaluation is that, except for the direct evaluation of bone, the tissues involved in the OA process are either evaluated indirectly (cartilage) or not at all (synovium). In evaluation of clinical OA, the scores for pain, stiffness and function are commonly used outcome measures. The objective of this study was to co-relate the clinical status with activity and radiological score in osteoarthritis of various joints.

MATERIALS AND METHODS

A Cross-sectional study was conducted including 100 consecutive patients of osteoarthritis of various joints. A thorough clinical examination of affected joint was performed and relevant laboratory investigations and radiology of the affected joint was done in all patients. Grading of severity of osteoarthritis was assessed by following clinical indices: Knee/ Hip by Lequesne, Articular Index of Doyle for osteoarthritis and modified WOMAC index - KGMC index. Radiological indices used were: Kellgren and Lawrence global grading scheme for the severity of osteoarthritis of the knee, hip, lumbar disc degeneration and apophyseal joints of the cervical spine, Kallman grading scale for individual features of the hand and Individual radiographic features assessed in radiographs of the hip and lumbar spine.

RESULTS

Knee joint was commonly involved (89%), followed by lumbar spine (49%). Knee joint tenderness was significantly co-relating with KGMC and radiological index. Lequesne and KGMC Indian index were co-relating positively with each other for knee joint. All clinical indices showed significant co-relation with radiological indices for knee joint. Clinical and radiological indices were also co-relating positively in cervical and lumbar spine. Visual analogue scale (VAS) co-related significantly with Lequesne and Indian KGMC index with respect to knee joint, but showed no co-relation with Doyle index. Also for hands, cervical and lumbar spine VAS and clinical indices did not co-relate.

CONCLUSION

KGMC index is best applicable to assess the osteoarthritis knee joint. Radiological progression in OA co-relates well with all clinical indices including KGMC index. This study highlights the usefulness of visual analogue scale and various radiological and clinical indices to assess osteoarthritis especially for knee joint.