scholarly journals Impact of ultrasonography detected quadriceps calcific tendinopathy on pain and function in patients with primary knee osteoarthritis

Reumatismo ◽  
2021 ◽  
Vol 73 (2) ◽  
pp. 111-116
Author(s):  
M.A. Mortada ◽  
L.I. Kotb ◽  
Y.A. Amer
Keyword(s):  
Knee Osteoarthritis ◽  
Vastus Lateralis ◽  
Health Assessment ◽  
Cross Sectional Study ◽  
Knee Joints ◽  
Cross Sectional ◽  
Calcific Tendinopathy ◽  
Knee Oa ◽  
Grade 3 ◽  
And Function

Calcific tendinopathy is most commonly seen around the shoulder joint. Only a few cases of quadriceps calcific tendinopathy (QCT) were reported. This study compares pain, function, clinical examination results, and ultrasonographic findings among primary knee osteoarthritis (KOA) patients with or without ultrasonography-detected QCT. A cross-sectional study was conducted on 214 patients with knee OA. Ultrasonography (US) of knee joints was performed according to the EULAR guidelines. Kellgren-Lawrence radiographic grading was used to score OA. Pain and functional status were assessed using the visual analog scale (VAS), the Health Assessment Questionnaire-II (HAQ-II), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). QCT was detected in 50 out of 428 knees (11.6%), i.e. in 46 out of 214 patients (21.49%). Most cases of QCT were detected in the following sites: 36 in the vastus lateralis (72%), 10 in the vastus intermedius (20%), and only 4 in the vastus medialis (8%). QCT was found mainly in advanced KOA stages: 44 cases of QCT were found in patients with grade 4 KOA and 6 cases in grade 3 KOA. The presence of QCT showed a statistically significant association (p<0.05) with VAS, HAQ-II, WOMAC subscales, synovitis, and effusion detected by US. In knees with ultrasound-detected QCT, ultrasonographic features of CPPD were found in 31 knees (62%). QCT was found in cases with advanced KOA and mainly with ultrasonographic findings of CPPD disease. QCT could be considered an independent poor prognostic finding regarding pain, functional activity, and response to NSAIDs.

scholarly journals FRI0390 IMPACT OF ULTRASONOGRAPHY‑DETECTED QUADRICEPS CALCIFIC TENDONITIS ON PAIN AND FUNCTION IN PATIENTS WITH PRIMARY KNEE OSTEOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 793.3-793
Author(s):  
M. A. Mortada ◽  
Y. A. Amer
Keyword(s):  
Knee Osteoarthritis ◽  
Vastus Lateralis ◽  
Health Assessment ◽  
Quadriceps Tendon ◽  
Knee Joints ◽  
Knee Oa ◽  
Vastus Intermedius ◽  
Calcific Tendonitis ◽  
Advanced Stages ◽  
And Function

Background:Calcific tendonitis is most commonly seen around shoulder joint. Few cases of quadriceps calcific tendonitis (QCT) of were reported. Routine use of ultrasonography in diagnosis of knee osteoarthritis has resulted in detection of many cases of QCT.Up to the best of our knowledge, this is the first study to detect impact of QCT in knee osteoarthritis by ultrasonography.Objectives:To compare pain, function, and clinical and radiological findings among primary KOA patients with or without ultrasonography-detected QCT.Methods:A prospective, observational study study was conducted on 214 patients with knee OA in the period between february 2019 to july 2019. Ultrasonography of knee joints was done according to EULAR guidelines. Quadriceps calcific tendonitis is defined as hyperechoic mass within the quadriceps tendon with posterior shadowing. The patients were categorized into two groups according to the presence or absence of QCT.Radiological grades of Kellgren–Lawrence were recorded. Pain and functional status was assessed by visual analog scale (VAS), Health Assessment Questionnaire-II (HAQ-II), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)Results:QCT were detected in 25 (11.6%) patients. Most cases of QCT were detected in vastus lateralis 18 (72%), then in vastus intermedius 5 (20%) and only 2 cases were detected in vastus medialis.QCT were detected mainly in advanced stages of knee OA; 22 cases of QCT were found in patients with grade 4 KOA.The presence of QCT was statistically significant related (P< 0.05*) with age, VAS, HAQ-II, WOMAC subscales, synovitis and effusion.Conclusion:Quadriceps calcific tendonitis is not rare. Ultrasonography can detect QCT in many cases with advanced knee OA. QCT is associated with increased pain and dysfunction in knee OAReferences:NoneDisclosure of Interests:None declared

scholarly journals AB0853 IMPACT OF ULTRASONOGRAPHY‑DETECTED PES ANSERINE BURSITIS ON PAIN ANDFUNCTION IN PATIENTS WITH PRIMARY KNEE OSTEOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1734.2-1734
Author(s):  
M. A. Mortada ◽  
Y. A. Amer ◽  
R. Zaghlol
Keyword(s):  
Knee Osteoarthritis ◽  
Health Assessment ◽  
Cross Sectional Study ◽  
Radiological Findings ◽  
Cross Sectional ◽  
Symptomatic Knee ◽  
Significant Difference ◽  
Common Causes ◽  
And Function ◽  
Assessment Questionnaire

Background:Pes anserine bursitis (PAB) is one of the most common causes of knee pain. Hence, this study aimed to compare the pain and function among all primary knee osteoarthritis (KOA) patients with or without ultrasonic-detected PAB and the associated clinical and radiological findings.Objectives:To compare pain, function, and clinical and radiological findings among primary KOA patients with or without ultrasonography-detected PAB.Methods:A single-center cross-sectional study was conducted on 245 patients with primary KOA. Patients with more symptomatic knee examined by musculoskeletal ultrasound (MSUS), then according to the presence or abscence of PAB, the patients were categorized into two groups. To differentiate between grades of inflammation of PAB on ultrasonography, the authors developed a semi-quantitative scale (0–2) as follows: Grade 0, normal hyperechoic picture of pes anserine tendons without tendonitis or bursitis; Grade 1, mild hypoechogenicity and/ or mild swelling or mild loss of fibrillar pattern of the pes anserine tendon and/or mild anechoic effusion related to the tendons; and Grade 2, marked hypoechogenicity and/ or large swelling or marked loss of the pes anserine tendon and/or marked anechoic effusion related to the tendons.. Radiological grades of Kellgren–Lawrence were recorded. Pain and functional status was assessed by visual analog scale (VAS), Health Assessment Questionnaire-II (HAQ-II), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).Results:A total of 110 (44.9%) patients were diagnosed with PAB where 91 (82.7%) of them had Grade 1 and only 19 (17.3%) had Grade 2. The presence of PAB was statistically significant related (P< 0.05*) with age, VAS, HAQ-II, WOMAC subscales, synovitis, and radiographic Grades 3 and 4. However, there was no statistically significant difference (P≥ 0.05) between KOA patients without PAB and KOA patients with PAB, regarding sex, body mass index, baker cyst, and effusion.Conclusion:The presence of PAB on MUS is associated with increased pain and disability in KOA. MSUS should be more widely used to establish the association between PAB and symptom severity and disability among KOA patients.References:NoneDisclosure of Interests:None declared

THE EFFECT OF A TRIPOD CANE ON THE FUNCTIONAL MOBILITY OF PATIENTS WITH KNEE OSTEOARTHRITIS

2020 ◽  
Vol 5 (1) ◽  
pp. 29
Author(s):  
Nelson Sudiyono
Keyword(s):  
Knee Osteoarthritis ◽  
Cross Sectional Study ◽  
Functional Mobility ◽  
Cross Sectional ◽  
Knee Oa ◽  
Walking Aids ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee ◽  
Contralateral Hand ◽  
Painful Knee

Background: Canes have been recommended as walking aids for knee osteoarthritis to reduce the loading on the affected knee. Patients are usually recommended to hold the cane in the contralateral hand to the affected knee. Nevertheless, some patients prefer to hold the cane ipsilateral to the affected knee. However, the effect of using ipsilateral or contralateral tripod cane on functional mobility in patients with knee osteoarthritis is still unknown Objective: To compare the immediate effect of ipsilateral and contralateral tripod cane usage on functional mobility in patients with symptomatic knee osteoarthritis Method: This cross-sectional study involved 30 overweight or obese patients with symptomatic unilateral or bilateral knee osteoarthritis (Kellgren Lawrence grade 2 and 3) who never use a cane. Functional mobility was evaluated with Time Up and Go test in three conditions; without walking aid, with tripod cane contralateral and ipsilateral to the more painful knee. Results: The TUG time of aid-free walking is 4.75 (p < 0.001, 95% CI 3.79 - 5.71) seconds faster than ipsilateral cane use and 6.69 (p < 0.001, 95%CI 5.35 - 8.03) seconds faster than contralateral cane use. The TUG time of ipsilateral cane use is 1,94 (95% CI, 1.13 - 2.79) seconds faster than contralateral. Conclusion: Patients with symptomatic knee OA who use tripod cane ipsilateral to the more painful knee have higher functional mobility than the contralateral.

scholarly journals Association of Varus Thrust With Pain and Stiffness and Activities of Daily Living in Patients With Medial Knee Osteoarthritis

2016 ◽  
Vol 96 (2) ◽  
pp. 167-175 ◽  
Author(s):  
Naoto Fukutani ◽  
Hirotaka Iijima ◽  
Takahiko Fukumoto ◽  
Daisuke Uritani ◽  
Eishi Kaneda ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Predictor Variable ◽  
Cross Sectional Study ◽  
Sensitivity Analyses ◽  
Varus Alignment ◽  
Cross Sectional ◽  
Medial Knee ◽  
Knee Oa

Background Increasing evidence highlights potential associations between varus thrust and health domains associated with knee osteoarthritis (OA). Objective The aim of this study was to investigate the association between varus thrust and 2 subcategories—“pain and stiffness” and “activities of daily living (ADL)”—of the Japanese Knee Osteoarthritis Measure (JKOM). Design This was a cross-sectional study. Methods In total, 296 outpatients with knee OA visiting orthopedic clinics were enrolled. The inclusion criteria were age ≥50 years, medial knee OA and Kellgren-Lawrence (K/L) grade ≥1 in one or both knees, and the ability to walk independently. Standard posterior-anterior knee radiographs were measured for varus alignment. Participants were video recorded while walking and were evaluated for the presence or absence of varus thrust. Pain and stiffness of the knee joint and ADL were evaluated using the JKOM. Multivariate regressions (outcomes: pain and stiffness and ADL; predictor variable: varus thrust) were performed. Results Varus thrust was present in 46 (16.2%) of 284 patients. Multivariate regression analyses demonstrated that varus thrust is independently associated with pain and stiffness, adjusted for age, sex, body mass index, K/L grade, and varus alignment (β=.17, P=.005). However, the association between varus thrust and ADL was not significant (β=.11, P=.058). Based on sensitivity analyses, including participants of K/L grade 1 had little influence on this analysis. Limitations Only 16.2% of participants had a varus thrust. Moreover, a cause-effect relationship between varus thrust and pain and stiffness remains unknown due to the cross-sectional design of this study. Conclusions Varus thrust was associated with pain and stiffness in patients with medial knee OA. However, the association between varus thrust and ADL did not reach significance.

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 Alteration of Screw-home Movement in Patients With Knee Osteoarthritis: A Cross-sectional Study

2020 ◽  
Author(s):  
Jeongwoo Jeon ◽  
Dongyeop Lee ◽  
Jaeho Yu ◽  
Jinseop Kim ◽  
Sang Hoon Lhee ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Extension ◽  
Cross Sectional Study ◽  
Measurement Unit ◽  
Tibial Rotation ◽  
Sectional Study ◽  
Control Groups ◽  
Cross Sectional ◽  
Knee Oa ◽  
And Control

Abstract Background: Tibial rotation accompanying sagittal movement contains the phenomenon of screw-home movement of the knee, which plays an important role in knee stability during extension. This study aimed to investigate the alteration of screw-home movement in patients with knee osteoarthritis (OA).Methods: Participants (n =67) in this cross-sectional study were outpatients in the department of orthopedics of a general hospital and included patients with knee OA (n=31) and asymptomatic control subjects (n=36).Knee kinematic data were measured using an inertial measurement unit. The total tibial rotation was obtainedduring knee sagittal movement. The acquired angle of tibial rotation was divided into four periodseach extension and flexion. The total tibial rotation and the variation of each period were compared between the OA and control groups.Results: Significant differences arose between the OA and control groups in the total tibial rotation during knee extension and flexion(P< 0.001).The variation of tibial rotation was also significantly different between groups for all periods (P< 0.001; knee extensionat 70° to 45°,P = 0.014).Conclusions: We found a reduction in the total tibial rotation and loss of the screw-home movement in the unloaded OA knee. To normalize the screw-home movement, it is necessary to promote proper articular movement of the knee joint and suppress the hyperexcitability of the medial muscles.

scholarly journals Status gizi berhubungan positif dengan derajat nyeri sendi penderita osteoartritis lutut

2012 ◽  
Vol 8 (3) ◽  
pp. 144 ◽  
Author(s):  
Nyoman Kertia
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Knee Osteoarthritis ◽  
Body Mass ◽  
Joint Pain ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Knee Oa ◽  
Vas Score ◽  
Bivariate Correlation

Background: Knee osteoarthritis (OA) is a common disorder that is associated with significant morbidity, disability, and medical costs, particularly in its advanced stages. While the cause of knee OA remains unclear, it has been associated with various risk factors, such as age, sex, genetic predisposition, biomechanical, and obesity. Pain in osteoarthritis occurs due to combination of various factors. Pain significantly increases the medical and non medical cost in OA. Data showed that obesity will increase the mechanical stress and pain of knee OA. However, uncertainty remains regarding potential relationship between body mass index (BMI) and pain in osteoarthritis. Moreover, since obesity is one of modifiable and preventable risk factors for the onset and progression of the disease, it is important to know the correlation between BMI and severity of pain in knee OA.Objectives: To investigate the relationship between body mass index and severity of joint pain in knee osteoarthritis.Methods: A cross sectional study was conducted and subjects were osteoarthritis patients in rheumatology clinic of Sardjito general hospital. Body mass index and visual analogue scale (VAS) score were measured. Correlation between BMI and VAS score were analyzed by bivariate correlation test.Results: There were 80 patients with osteoarthritis who participated in the study. Mean BMI was 26.36 +4.23 kg/m2 and VAS score was 52.40+24.53 mm. The correlation test showed that there was a positive but non significant correlation between BMI and VAS scores (r = 0,11; p = 0,33).Conclusion: There was a positive but non significant correlation between body mass index and the severity of joint pain in knee osteoarthritis.

scholarly journals Exploring the relationship between pain intensity and knee moments in participants with medial knee osteoarthritis: a cross-sectional study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chen. Huang ◽  
Ping-Keung. Chan ◽  
Kwong-Yuen. Chiu ◽  
Chun-Hoi. Yan ◽  
Shun-Shing. Yeung ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Path Analysis ◽  
Pain Intensity ◽  
Cross Sectional Study ◽  
Knee Adduction Moment ◽  
Analysis Model ◽  
Cross Sectional ◽  
Knee Oa ◽  
The Relationship ◽  
External Knee Adduction Moment

Abstract Background High biomechanical loading is believed to be a risk factor to pain in people with knee osteoarthritis (OA), but controversial findings have been reported on the relationship between external knee adduction moment (KAM) and pain. A more comprehensive analysis considering other factor such as external knee flexion moment (KFM) could help better reveal this relationship. This study explored the relationship between external knee adduction moment and pain intensity in participants with knee osteoarthritis (OA) using an integrated path analysis model. Methods This was a cross-sectional study based on laboratory setting. Forty-seven participants with clinical and radiographic medial knee OA were analyzed for their external knee adduction moment (KAM) and knee flexion moment (KFM) during walking using a motion analysis system. Pain intensity was measured by visual analogue scale (VAS) and the pain subscale of the Knee Injury and Osteoarthritis Outcome Score. Varus/valgus alignment was captured and quantified using a bi-planar X-ray system. Using a path analysis model, the relationships between pain intensity, KAM, KFM, OA radiographic severity, knee varus angle and walking speed were examined. Results The proposed path model met the goodness-of-fit criteria. Based on this model, KAM had a negative effect on VAS pain indirectly through the mediation of KFM. The model indicated KAM and KFM were negatively related to one another; and KFM was positively related to VAS. The KAM index, defined as (KAM/ (KAM + KFM)), was negatively related to VAS. Conclusions Path analysis enabled the construction of a more integrated pathokinematic framework for people with knee OA. The KAM index which reflected the load sharing on the frontal and sagittal planes also revealed its relationship with pain. Re-distribution of mechanical loading from frontal to sagittal plane might be a strategy for pain avoidance associated with mechanical irritation.

scholarly journals The Correlation of Supra Patella Effusion With Pain and Disability in Patients With Knee Osteoarthritis

2020 ◽  
Vol 18 (2) ◽  
pp. 155-162
Author(s):  
Anahita Hasannejad ◽  
◽  
Hasan Namvar ◽  
Kamran Ezzati ◽  
Fatemeh Ghiasi ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Knee Osteoarthritis ◽  
Analogue Scale ◽  
Sampling Method ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Knee Oa ◽  
Relationship Of ◽  
The Relationship

Objectives: The present research aimed to evaluate the relationship of supra patella effusion with pain and disability in patients with knee osteoarthritis by Ultrasonography (US). Methods: In a cross-sectional study, 60 patients with knee OA (Mean±SD score of body mass index: 29.81±5.64 kg/m2 and age: 50.48±7.57 years) were selected by nonprobability sampling method. Supra patella effusion was evaluated using an US. All study subjects completed the Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for pain and disability outcomes, respectively. To evaluate the relationship between effusion, disability, and pain, the Pearson’s correlation coefficient was employed.  Results: There was a poor but significant relationship between the area of effusion (r=0.27, P=0.03), the thickness of effusion (r=0.32, P=0.01), with pain. No correlation was found between the trace of effusion (r=-0.08, P=0.5) and pain. The area of effusion (r=0.1, P=0.17), the thickness of effusion (r=0.08, P=0.51), and the trace of effusion (r=0.0, P=0.9) were not correlated with disability.  Discussion: The effusion of supra patella was slightly correlated with pain. In contrast, the effusion of supra patella demonstrated no correlation with disability.

The Importance of Functional Hamstring/Quadriceps Ratios in Knee Osteoarthritis

2020 ◽  
Vol 29 (7) ◽  
pp. 866-870
Author(s):  
Özlem Aslan ◽  
Elif Balevi Batur ◽  
Jale Meray
Keyword(s):  
Patient Group ◽  
Critical Role ◽  
Peak Torque ◽  
Knee Extension ◽  
Cross Sectional Study ◽  
Control Group ◽  
Cross Sectional ◽  
Knee Oa ◽  
Hamstring Muscles ◽  
Grade 3

Context: Osteoarthritis (OA) is the most common chronic joint condition. Muscle dysfunction plays a critical role in the pathogenesis of knee OA. Objective: It has been suggested that the agonist–antagonist strength relationship for the knee may be better described by a functional hamstring/quadriceps (H/Q) ratio (Hconcentric/Qeccentric: the representative of knee flexion and Qeccentric/Hconcentric: the representative of knee extension). Therefore, in this study, the authors aimed to investigate this ratio and its importance for knee OA. Design: Cross-sectional study. Setting: Research clinic. Patients or Other Participant(s): Twenty healthy women and 20 women with grade 2 or grade 3 primer knee OA between the age of 50 and 80 years were included in this study. Intervention(s): Concentric and eccentric peak torque of quadriceps and hamstring muscles were evaluated for all individuals in patient and control groups with a Cybex isokinetic device. Functional H/Q ratio is calculated manually. Main Outcome Measure(s): Functional H/Q torque ratios were analyzed between the patients with OA and healthy individuals by using the isokinetic system. Results: The values of peak torque of hamstring concentric and eccentric and quadriceps concentric for the patient group were significantly lower than the control group (P < .05). No statistically important difference was found for quadriceps eccentric peak torque between 2 groups (P > .05). H/Q ratio for extension in the patient group was significantly higher than the control group (P < .05), whereas the H/Q ratio for flexion in the patient group was significantly lower than the control group (P < .05). Conclusion: This study showed the weakness of both quadriceps and hamstring muscles in patients with knee OA. The combination of functional H/Q ratio with hamstring and quadriceps muscles concentric and eccentric strength values can help to analyze the knee functions and develop preventive-therapeutic approaches for knee OA.

Sign in / Sign up

Export Citation Format

Share Document