scholarly journals Relation of radiographic severity of knee osteoarthritis to clinical pain scores: results from the pain perception in osteoarthritis study

2018 ◽  
Vol 26 ◽  
pp. S223-S224
Author(s):  
L. Assi ◽  
A. Harrison ◽  
A. Kuttapitiya ◽  
F. Howe ◽  
V. Ejindu ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Pain Perception ◽  
Radiographic Severity ◽  
Pain Scores ◽  
Clinical Pain

Pain perception in chronic knee osteoarthritis with varying levels of pain inhibitory control: an exploratory study

2020 ◽  
Vol 20 (4) ◽  
pp. 651-661
Author(s):  
Paulo E. P. Teixeira ◽  
Hanan I. Zehry ◽  
Swapnali Chaudhari ◽  
Laura Dipietro ◽  
Felipe Fregni
Keyword(s):  
Knee Osteoarthritis ◽  
Pain Intensity ◽  
Pain Perception ◽  
Small Sample Size ◽  
Linear Regression Analysis ◽  
Small Sample ◽  
Pain Modulation ◽  
Clinical Variables ◽  
Pain Scores ◽  
Intensity Perception

AbstractBackground and aimsPain is a disabling symptom in knee osteoarthritis (KOA) and its underlying mechanism remains poorly understood. Dysfunction of descending pain modulatory pathways and reduced pain inhibition enhance pain facilitation in many chronic pain syndromes but do not fully explain pain levels in chronic musculoskeletal conditions. The objective of this study is to explore the association of clinical variables with pain intensity perception in KOA individuals with varying levels of Conditioned Pain Modulation (CPM) response.MethodsThis is a cross-sectional, exploratory analysis using baseline data of a randomized clinical trial investigating the effects of a non-invasive brain stimulation treatment on the perception of pain and functional limitations due to KOA. Sixty-three subjects with KOA were included in this study. Data on pain perception, mood perception, self-reported depression, physical function, quality of life, and quantitative sensory testing was collected. Multiple linear regression analysis was performed to explore the association between the clinical variables with pain perception for individuals with different levels of CPM response.ResultsFor KOA patients with limited CPM response, perception of limitations at work/other activities due to emotional problems and stress scores were statistically significantly associated with pain scores, F(2, 37) = 7.02, p < 0.01. R-squared = 0.275. For KOA patients with normal CPM response, general health perception scores were statistically significantly associated with pain scores, F(1, 21) = 5.60, p < 0.05. R-squared = 0.2104. Limitations of this study include methodology details, small sample size and study design characteristics.ConclusionsPain intensity perception is associated differently with clinical variables according to the individual CPM response. Mechanistic models to explain pain perception in these two subgroups of KOA subjects are discussed.

scholarly journals High-Dose Daily Opioid Administration and Poor Functional Status Intensify Local Anesthetic Injection Pain in Cancer Patients

2013 ◽  
Vol 3;16 (3;5) ◽  
pp. E247-E256
Author(s):  
Kyung Bong Yoon
Keyword(s):  
Functional Status ◽  
Cancer Patients ◽  
Local Anesthetic ◽  
Pain Perception ◽  
Injection Pain ◽  
High Dose ◽  
Pain Scores ◽  
Clinical Pain ◽  
Local Anesthetic Injection ◽  
And Behavior

Background: Evidence for opioid-induced hyperalgesia (OIH) has been shown in animal and human studies, but the clinical implications of this phenomenon remain unclear. Objectives: We examined whether cancer patients taking opioids differ in their sensitivity to a clinical pain stimulus using a local anesthetic injection compared to those not taking opioids. We also evaluated the effect of the opioid dose, duration of opioid therapy, and patients’ pain severity and functional status on this clinical pain stimulus. Study Design: Prospective observational study. Setting: University outpatient department for interventional pain management, Republic of Korea. Methods: Eighty-two cancer patients including 20 patients not taking opioids (non-opioid group) and 62 taking opioids (opioid group) who were scheduled for an interventional procedure were enrolled in this study. Patients received a standardized subcutaneous injection of lidocaine prior to a full dose of local anesthetic (LA). Before the injection, patients completed the Brief Pain Inventory (BPI) questionnaire and were asked to rate their current pain using numeric rating scales. Immediately following the injection, LA injection-specific pain was evaluated using pain intensity, unpleasantness, and behavior pain scores. Results: LA injection-specific pain intensity, unpleasantness, and behavior pain score were significantly higher in the opioid group compared with the non-opioid group (P < 0.001). In the opioid group, these post-injection pain scores were higher in patients taking high-dose opioids than those taking low doses (P < 0.05). In addition, we observed a strong correlation between the baseline BPI pain interference score and the LA injection-specific pain score (r = 0.695, P < 0.001). Limitations: This study is limited by its sample size and observational design. Various opioid medications, which were not standardized, may have inadvertently biased our results. Finally, the pain assessed by a brief stimulus does not fully reflect disturbances in endogenous pain inhibitory processes. Conclusion: The results of this study suggest that opioid medication is an important contributing factor to pain perception accompanying LA injection, and cancer patients using high-dose opioids may be highly susceptible to hyperalgesic responses to this clinical stimulus. We also suggest that the possible presence of OIH may be intensified among cancer patients with poor physical and psychosocial functional status. Key words: Adverse effects; analgesics, opioid; anesthetics, local; cancer; hyperalgesia; injections, subcutaneous; nociceptive pain; pain measurement; pain perception; quality of life

A118G Single Nucleotide Polymorphism of Human μ-Opioid Receptor Gene Influences Pain Perception and Patient-controlled Intravenous Morphine Consumption after Intrathecal Morphine for Postcesarean Analgesia

2008 ◽  
Vol 109 (3) ◽  
pp. 520-526 ◽  
Author(s):  
Alex T. Sia ◽  
Yvonne Lim ◽  
Eileen C. P. Lim ◽  
Rachelle W. C. Goh ◽  
Hai Yang Law ◽  
...  
Keyword(s):  
Opioid Receptor ◽  
Pain Perception ◽  
Intrathecal Morphine ◽  
Receptor Gene ◽  
Mu Opioid Receptor ◽  
Morphine Consumption ◽  
Mu Opioid ◽  
Pain Scores ◽  
Significant Difference ◽  
Intravenous Morphine

Background Previous studies have shown that genetic variability at position 118 of the human mu-opioid receptor gene altered patients' response to intravenous morphine. The purpose of this study was to investigate whether this polymorphism contributes to the variability in response to morphine for postcesarean analgesia. Methods After investigators obtained informed consent, 588 healthy women received 0.1 mg intrathecal morphine for postcesarean analgesia. Their blood samples were genotyped for the A118G polymorphism-A118 homozygous (AA), heterozygous (AG), or homozygous for the G allele (GG). Pain scores, the severity of nausea and vomiting, the incidence of pruritus, and the total self-administered intravenous morphine were recorded for the first 24 postoperative hours. Results Two hundred seventy women (46%) were AA, 234 (40%) were AG, and 82 (14%) were GG. The 24-h self-administered intravenous morphine consumption was lowest in the AA group (P = 0.001; mean, 5.9; 95% confidence interval, 5.1-6.8) versus the AG (8.0; 6.9-9.1) and GG groups (9.4; 7.3-11.5). Pain scores were lowest in the AA group and highest in the GG group, with a statistically significant difference detected between AA, AG, and GG (P = 0.049). Total morphine consumption was also influenced by patients' age and paying status. AA group was associated with the highest incidence of nausea (26 of 272 [9.6%]; P = 0.02) versus the other two groups (13 of 234 [5.6%] and 1 of 82 [1.2%] for AG and GG, respectively). Conclusion Genetic variation at position 118 of the mu-opioid receptor is associated with interindividual differences in pain scores, self-administered intravenous morphine, and the incidence of nausea postoperatively.

Synovitis is associated with constant pain in knee osteoarthritis: a cross-sectional study of OMERACT knee ultrasound scores

2021 ◽  
pp. jrheum.210285
Author(s):  
Holly T. Philpott ◽  
Trevor B. Birmingham ◽  
Ryan Pinto ◽  
Codie A. Primeau ◽  
Dominique Arsenault ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Multinomial Logistic Regression ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Knee Oa ◽  
Pain Scores ◽  
Constant Pain ◽  
Secondary Analyses ◽  
Pain Experiences

Objective To examine the association between ultrasound (US)-detected knee inflammation and intermittent and constant pain experiences in patients with knee osteoarthritis (OA). Methods Participants with radiographically early- (KL ≤ 2) and late-stage (KL ≥ 3) disease and frequent symptoms underwent musculoskeletal US measures of inflammation using the OMERACT knee US scoring system. Pain experiences were captured using the Intermittent and Constant OA Pain (ICOAP) tool. We assessed the association between US-synovitis and ICOAP pain experiences using a series of linear, logistic, or multinomial logistic regression models (as appropriate for each variable), while adjusting for age, sex, body mass index (BMI), and radiographic stage. Secondary analyses were performed similarly by radiographic stage. Results Pain and synovitis measures from 248 patients (453 knees) were included. Worse synovitis was associated with higher ICOAP constant pain scores (β 8.05 [95%CI 0.67, 15.43]), but not intermittent pain scores. Moderate-to-severe synovitis was associated with a 4.73-fold increased relative risk [95%CI 1.06, 8.80] of a constant pain pattern. In secondary analyses, moderate-to-severe synovitis in early radiographic OA was associated with 2.70-higher odds [95%CI 1.04, 7.02] of any constant pain, 3.28-higher odds [95%CI 1.43, 7.52] of any intermittent pain, and with higher intermittent (β 10.47 [95%CI 1.03, 19.91]) and constant (β 12.62 [95%CI 3.02, 22.23]) pain scores. No associations identified for synovitis in those with late radiographic OA. Conclusion In patients with knee OA, moderate-to-severe synovitis is most strongly associated with constant pain. Inflammation may play context-specific roles across pain experiences, especially in earlier radiographic stages of knee OA.

scholarly journals Offset Analgesia in Neuropathic Pain Patients and Effect of Treatment with Morphine and Ketamine

2011 ◽  
Vol 115 (5) ◽  
pp. 1063-1071 ◽  
Author(s):  
Marieke Niesters ◽  
Elske Hoitsma ◽  
Elise Sarton ◽  
Leon Aarts ◽  
Albert Dahan
Keyword(s):  
Neuropathic Pain ◽  
Pain Score ◽  
Pain Perception ◽  
Spontaneous Pain ◽  
Noxious Heat ◽  
Convenience Sample ◽  
Pain Scores ◽  
Effect Of Treatment ◽  
Age Range ◽  
Pain Patients

Background Offset analgesia, in which a disproportionally large amount of analgesia becomes apparent upon a slight decrease in noxious heat stimulation, has not been described previously in patients with chronic pain. Methods Offset analgesia responses in 10 patients with neuropathic pain (in both legs) were compared with 10 matched healthy controls and volunteers from a convenience sample (n = 110) with an age range of 6-80 yr. Offset analgesia was defined by the reduction in electronic pain score upon the 1°C decrease in noxious heat stimulus relative to the peak pain score where pain was administered at the volar side of the arm. Results Offset analgesia was present in healthy volunteers irrespective of age and sex (pain score decrease = 97 ± 1% [mean ± SEM]). In contrast, a reduced or absent offset analgesia response was observed in patients with neuropathic pain (pain score decrease = 56 ± 9% vs. controls 98 ± 1%, P &lt; 0.001). Intravenous treatment with ketamine, morphine, and placebo had no effect on offset analgesia in patients, despite sharp reductions in spontaneous pain scores. Conclusions These data indicate that offset analgesia is fully developed at the age of 6 yr and does not undergo additional maturation. The reduced or absent responses observed in patients with chronic neuropathic pain indicate the inability to modulate changes in pain stimulation, with perseverance of pain perception in situations in which healthy subjects display signs of strong analgesia. Both central and peripheral sites may be involved in the altered offset analgesia responses in these patients.

(205) The role of clinical pain in the association between vitamin D status and sleep quality among adults with knee osteoarthritis

2014 ◽  
Vol 15 (4) ◽  
pp. S27
Author(s):  
M. Petrov ◽  
T. Glover ◽  
B. Goodin ◽  
L. Bradley ◽  
R. Fillingim
Keyword(s):  
Vitamin D ◽  
Sleep Quality ◽  
Knee Osteoarthritis ◽  
Vitamin D Status ◽  
Clinical Pain

Soluble P selectin in synovial fluid level is correlated with the radiographic severity of knee osteoarthritis

2010 ◽  
Vol 411 (19-20) ◽  
pp. 1529-1531 ◽  
Author(s):  
Tao Cheng ◽  
Feng-Feng Li ◽  
Song Zhao ◽  
Xiao-Chun Peng ◽  
Xian-Long Zhang
Keyword(s):  
Synovial Fluid ◽  
Knee Osteoarthritis ◽  
Fluid Level ◽  
Synovial Fluid Level ◽  
Radiographic Severity ◽  
Soluble P

Convolutional Neural Network-Based Automatic Measurement of Joint Space Width to Predict Radiographic Severity and Progression of Knee Osteoarthritis

2021 ◽  
Author(s):  
James Chung Wai Cheung ◽  
Yiu Chow TAM ◽  
Lok Chun CHAN ◽  
Ping Keung CHAN ◽  
Chunyi WEN
Keyword(s):  
Neural Network ◽  
Knee Osteoarthritis ◽  
Convolutional Neural Network ◽  
Pearson Correlation ◽  
Joint Space Width ◽  
Joint Space ◽  
Receiver Operating Curve ◽  
Radiographic Severity ◽  
X Ray ◽  
Space Width

Abstract Objectives To develop a deep convolutional neural network (CNN) for the segmentation of femur and tibia on plain x-ray radiographs, hence enabling an automated measurement of joint space width (JSW) to predict the severity and progression of knee osteoarthritis (KOA). Methods A CNN with ResU-Net architecture was developed for knee X-ray imaging segmentation. The efficiency was evaluated by the Intersection over Union (IoU) score by comparing the outputs with the annotated contour of the distal femur and proximal tibia. By leveraging imaging segmentation, the minimal and multiple JSWs in the tibiofemoral joint were estimated and then validated by radiologists’ measurements in the Osteoarthritis Initiative (OAI) dataset using Pearson correlation and Bland–Altman plot. The estimated JSWs were deployed to predict the radiographic severity and progression of KOA defined by Kellgren-Lawrence (KL) grades using the XGBoost model. The classification performance was assessed using F1 and area under receiver operating curve (AUC). Results The network has attained a segmentation efficiency of 98.9% IoU. Meanwhile, the agreement between the CNN-based estimation and radiologist’s measurement of minimal JSW reached 0.7801 (p < 0.0001). Moreover, the 32-point multiple JSW obtained the highest AUC score of 0.656 to classify KL-grade of KOA. Whereas the 64-point multiple JSWs achieved the best performance in predicting KOA progression defined by KL grade change within 48 months, with AUC of 0.621. The multiple JSWs outperform the commonly used minimum JSW with 0.587 AUC in KL-grade classification and 0.554 AUC in disease progression prediction. Conclusion Fine-grained characterization of joint space width of KOA yields comparable performance to the radiologist in assessing disease severity and progression. We provide a fully automated and efficient radiographic assessment tool for KOA.

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