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因膝部不适而计划进行的或近期首次与全科医生的会诊:这是否表明为早期膝骨关节炎?

Planned or recent first consultation with the general practitioner for knee complaints: Is it indicative of early-stage knee osteoarthritis?

作者信息

Jansen Nuria Ej, Schiphof Dieuwke, Runhaar Jos, Oei Edwin Hg, Bierma-Zeinstra Sita Ma, Middelkoop Marienke van

机构信息

Department of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands.

Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, the Netherlands.

出版信息

Osteoarthr Cartil Open. 2024 Jun 6;6(3):100493. doi: 10.1016/j.ocarto.2024.100493. eCollection 2024 Sep.

Abstract

OBJECTIVE

No established definition for early-stage knee osteoarthritis (KOA) is available, nor classification criteria. Identifying the characteristics of individuals presenting with early-stage KOA symptoms can enhance diagnosis to prevent progression. This study aimed to describe clinical and structural features of individuals presenting with knee complaints within two years after their first consultation, while exploring differences in the duration of knee complaints.

METHOD

Baseline data was used from the LITE randomized controlled trial, assessing the effectiveness of a lifestyle intervention for individuals with knee complaints and overweight in primary care. Baseline assessments included questionnaires, clinical assessment, and MRI of the most symptomatic knee. Differences between groups with varying durations of knee complaints (<12, ≥12-<24, ≥24 months) were evaluated.

RESULTS

Participants (N ​= ​218, 65% female, mean age 59 ​± ​6 years, mean BMI 32 ​± ​5 ​kg/m) had a median knee complaint duration of 14 months, with an average KOOS pain score of 60 ​± ​17.46% reported their symptoms as unacceptable. Structural MRI-defined KOA was observed in 71% of participants. There were no significant differences in clinical or structural MRI features between different durations of knee complaints.

CONCLUSION

Within 24 months of initial consultation, over two-thirds of participants displayed MRI-defined structural KOA, and nearly half reported unacceptable symptom states. This study found no association between the duration of knee complaints and symptoms severity or structural KOA presence, underscoring the complexity of identifying stages of KOA among individuals with overweight. Future studies should explore additional features beyond current considerations to facilitate early-stage KOA diagnosis, specifically for individuals with overweight.

摘要

目的

目前尚无早期膝关节骨关节炎(KOA)的确切定义和分类标准。识别出现早期KOA症状个体的特征可加强诊断以预防病情进展。本研究旨在描述初次就诊后两年内出现膝关节问题个体的临床和结构特征,同时探讨膝关节问题持续时间的差异。

方法

使用LITE随机对照试验的基线数据,评估生活方式干预对基层医疗中膝关节问题且超重个体的有效性。基线评估包括问卷调查、临床评估以及最具症状膝关节的MRI检查。评估膝关节问题持续时间不同(<12个月、≥12至<24个月、≥24个月)的组间差异。

结果

参与者(N = 218,65%为女性,平均年龄59±6岁,平均BMI 32±5 kg/m²)膝关节问题的中位持续时间为14个月,平均膝关节损伤和骨关节炎疗效评分(KOOS)疼痛评分为60±17.46%,其中有症状者表示症状难以忍受。71%的参与者通过MRI观察到结构性KOA。膝关节问题不同持续时间在临床或结构MRI特征方面无显著差异。

结论

在初次就诊后的24个月内,超过三分之二的参与者通过MRI观察到结构性KOA,近一半参与者表示症状难以忍受。本研究发现膝关节问题持续时间与症状严重程度或结构性KOA的存在之间无关联,这凸显了在超重个体中识别KOA阶段的复杂性。未来研究应探索当前考虑因素之外的其他特征,以促进早期KOA的诊断,特别是针对超重个体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f77c/11223112/0fd7c055e6e4/gr1.jpg

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