Pain while using stairs could be early indicator of osteoarthritis

 Toward a clinical definition of early osteoarthritis: onset of patient-reported knee pain begins on stairs. Data from the osteoarthritis initiative.

Hensor EMA. Arthritis Care Res 2014. doi:10.1002/acr.22418
December 29, 2014
 
 
OSTEOARTHRITIS
   
 

Pain while using stairs could be early indicator of osteoarthritis
Knee pain while climbing stairs was shown to be an early indicator of the development of osteoarthritis in individuals at high risk for the disease. Read more
 Dolor durante el uso de escaleras podría ser indicador temprano de la osteoartritis
El dolor de rodilla, mientras se suben escaleras ha demostrado ser un indicador temprano del desarrollo de la artrosis en individuos de alto riesgo para la enfermedad

Arthritis Care Res (Hoboken). 2015 Jan;67(1):40-7. doi: 10.1002/acr.22418.

Toward a clinical definition of early osteoarthritis: onset of patient-reported knee pain begins on stairs. Data from the osteoarthritis initiative.

Hensor EM1, Dube B, Kingsbury SR, Tennant A, Conaghan PG.

Author information

Abstract

OBJECTIVE:

Early detection of osteoarthritis (OA) would increase the chances of effective intervention. We aimed to investigate which patient-reported activity is first associated with knee pain. We hypothesized that pain would occur first during activities requiring weight bearing and knee bending.
 OBJETIVO:

La detección temprana de la osteoartritis (OA) aumentaría las posibilidades de intervención efectiva. El objetivo fue investigar que el paciente reportado actividad se asoció primero con dolor de rodilla. La hipótesis de que el dolor se produciría por primera vez durante las actividades que requieren soporte de peso y la  flexión de rodilla.

METHODS:

Data were obtained from the Osteoarthritis Initiative (OAI), a multicenter, longitudinal prospective observational cohort of people who have or are at high risk of OA. Participants completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC; Likert scale) annually for up to 7 years. Rasch analysis was used to rank the WOMAC pain questions (activities) in order of affirmation as the pain score increased from 0. For each total WOMAC score category (0-20) we selected 25 individuals at random based on their maximum score across all visits. Fit to the Rasch model was assessed in this subset; stability of question ranking over successive visits was confirmed in the full OAI.

RESULTS:

WOMAC data on 4,673 people were included, with 491 selected for subset analysis. The subset data showed good fit to the Rasch model (χ(2) = 43.31, P = 0.332). In the full OAI, the "using stairs" question was the first to score points as the total pain score increased from 0 (baseline logit score ± 95% confidence interval -4.74 ± 0.07), then "walking" (-2.94 ± 0.07), "standing" (-2.65 ± 0.07), "lying/sitting" (-2.00 ± 0.08), and finally "in bed" (-1.32 ± 0.09). This ordering was consistent over successive visits.

CONCLUSION:

Knee pain is most likely to first appear during weight-bearing activities involving bending of the knee, such as using stairs. First appearance of this symptom may identify a group suitable for early intervention strategies.
© 2015 The Authors. Arthritis Care & Research is published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology.
PMID:
 
25074673
 
[PubMed - in process]