Rapid Structural Damage Drives Pain and Dysfunction in Early OA
Saturday, March 14, 2015 04:14 PM

In patients with early symptomatic osteoarthritis (OA), pain and physical functioning remain fairly stable over the medium term of 4 or 5 years, especially in those with slow radiographic progression. Rapid radiographic progression, however, is associated with increased pain and diminished function, according to a two-cohort comparative study. "For the physician, these findings ... may provide a legitimation for symptomatic treatment." 

Drawing on data from almost 2,300 participants from 12 centers in the Osteoarthritis Initiative (OAI) and the Cohort Hip and Cohort Knee (CHECK) study, the Dutch analysis aimed to expand the sparse information on the interaction between radiographic joint damage and the evolution of pain and physical functioning. "Knee pain is often the first sign of knee osteoarthritis, and it is known that its evolution can be very different between patients," they wrote.

Participants, ages 45 to 65, with pain or stiffness in the knee or hip were assessed for the two outcomes of pain and function at baseline and again at follow-up. All underwent posterior-anterior weight-bearing radiographs of both tibiofemoral joints to assess the knees, and radiographic change was measured from baseline to follow-up. 

"The findings suggest it was not so much the presence of joint damage at the knee that was important for the evolution of pain and function, but rather the worsening of joint damage [at] medium term," the authors wrote. Apparently, there must be a larger change in structural deterioration to have [an] effect on the evolution of pain and function."

Source:  http://www.medpagetoday.com/Rheumatology/Arthritis/49578