The Association between Multiple Pain Locations with Knee Osteoarthritis

Abstract

Osteoarthritis is a common age related disorder of synovial joints which primarly involves articular cartilage,synovium and subconderal bones.OA has become the most prevalent form of joint disease in developed countries(Kotlarz et al., 2001). The present study was designed to find possible association between knee OA and concurrent joints pain in osteoarthritic pateints. We conducted our study on fifty OA patients and ten healthy subjects serving as control group. All patients and control groups were subjected to history taking, ,self reported WOMAC score, clinical examination, laboratory investigations as CBC, ESR, SGOT, SGPT, T3,T4, TSH, fasting blood sugar, serum urea and creatinine, serum uric acid and complete urine analysis, and radiological score according to(Kellgren and Lawernce,1963) to knee joint, lumbosacral, ankle joint and elbow joint. The present study revealed: WOMAC score and VAS were significantly higher in patients than in control. Patients with score (3) knee tenderness had high WOMAC score Which was highly statistically significant. Patients with moderate knee swelling had high WOMAC score which was highly statistically significant. Patients with ROM of motion grade (2) had high statistically significance with WOMAC score. There was highly statistical significance between WOMAC score and knee X-ray on(Kellgren and Lawrence,1963) grading system grade 3 and statistical significance with knee X ray grade 2. There was no statistical significance between WOMAC score and lumbosacral, ankle and elbow X-ray on(Kellgren and Lawrence,1963) grading system. Patients had more than 8 pain locations had the highest WOMAC score while patients had 2-3 sites pain locations had the lowest WOMAC score. There were significant positive correlations between WOMAC score, age, weight, BMI and VAS and insignificant correlation between height and disease duration. We concluded that: 1. WOMAC score had highly significant relation with moderate knee swelling,ROM grade 1 and 2,knee tenderness grade 2 and 3, and presence of moderate and large multiple osteophytes, definite narrowing of joint space, sclerosing and possible deformity of bone contour in knee x ray. 2. The presence of multiple muscluoskeletal pain locations other than knee were related with high knee WOMAC score.