Kawasaki T, Inoue K, Ushiyama T, Fukuda S
Department of Orthopaedic Surgery, Shiga University of Medical Science.
Ryumachi. 1998 Feb;38(1):2-5.
Radiological examination is essential in diagnosing osteoarthritis (OA) of the knee. However, diagnoses that are not based on radiological examination are preferred in epidemiological studies, and the American College of Rheumatology (ACR) has recommended classification criteria for OA of the knee based on clinical examination, and indicated that these classification criteria were appropriate for epidemiological studies. To evaluate the validity of this criteria, we examined the interobserver reproducibility as well as the sensitivity and specificity of the criteria for outpatient attenders complaining knee pain with wide spectrum of rheumatic diseases. As a result, interobserver reproducibility was considered good, but both sensitivity and specificity were slightly lower than the report by ACR in which representative rheumatic diseases such as rheumatoid arthritis were chosen as control. We therefore consider that ACR classification criteria for OA of the knee in of value, but that radiological examination should be preferred in case it is possible.
放射学检查对于诊断膝关节骨关节炎（OA）至关重要。然而，在流行病学研究中，不基于放射学检查的诊断更为可取，美国风湿病学会（ACR）已推荐了基于临床检查的膝关节OA分类标准，并指出这些分类标准适用于流行病学研究。为评估该标准的有效性，我们检查了观察者间的可重复性以及针对患有广泛风湿性疾病且主诉膝关节疼痛的门诊患者该标准的敏感性和特异性。结果，观察者间的可重复性被认为良好，但敏感性和特异性均略低于ACR的报告，ACR的报告中选择类风湿关节炎等代表性风湿性疾病作为对照。因此，我们认为ACR膝关节OA分类标准有价值，但在可能的情况下应优先进行放射学检查。
