title: Analysis of the discordance between radiographic changes and knee pain in osteoarthritis of the knee.
abstract: OBJECTIVE
  To analyze cross sectional data from the National Health and Nutrition Examination Survey (NHANES I) concerning 3 indicators of osteoarthritis (OA) of the knee: radiographic evidence of structural damage, self-reported knee pain, and self-report of a diagnosis of arthritis at any joint by a physician.
  
  
  METHODS
  Analysis of NHANES I data for 6880 persons ages 25-74 in the United States.
  
  
  RESULTS
  Radiographic stage 2-4 knee OA was found in 319 subjects (3.7%); only 47% of these individuals reported knee pain, and only 61% reported that a physician had told them that they had arthritis. Knee pain was reported by 1004 subjects (14.6%), only 15% of whom had radiographic stage 2-4 changes of OA, and 59% of whom reported having a diagnosis of arthritis by a physician. A report of arthritis diagnosed by a physician was given by 1762 subjects (25.6%), of whom only 11% had stage 2-4 radiographic knee OA and 34% reported knee pain.
  
  
  CONCLUSIONS
  Substantial discordance exists in this population based study between radiographic OA of the knee versus knee pain, versus a diagnosis of arthritis by a physician. These phenomena may be important in the design of clinical research studies, as well as in criteria for OA.
authors.affiliation: Hebrew Rehabilitation Center for Aged, Harvard Medical School Division on Aging, Boston, Massachusetts 02131-1097, USA. hannan@mail.hrca.harvard.edu
authors.forename: M T
authors.initials: MT
authors.lastname: Hannan
authors.forename: D T
authors.initials: DT
authors.lastname: Felson
authors.forename: T
authors.initials: T
authors.lastname: Pincus
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D010146:Pain / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015995:Prevalence; D011859:Radiography; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology