Knee osteoarthritis in community-dwelling older adults: are there characteristic patterns of pain location?
OBJECTIVE
To determine whether there are characteristic patterns of pain location associated with knee osteoarthritis (OA) among community-dwelling older adults.


METHODS
Population-based, cross-sectional survey of 697 adults aged 50 years and over reporting knee pain within the past 6 months. Pain at 13 individual sites at or around the knee was coded. Pain locations in participants with and without "symptomatic knee OA" (defined as symptoms on most days in the past month, at least a definite osteophyte on plain X-ray, and current pain intensity of at least 2 out of 10) were compared. Participants were then grouped by pattern of knee pain location, and their clinical and radiographic characteristics compared.


RESULTS
Generalised knee pain (n=313) and medial knee pain (either in isolation or with peripatellar or lateral knee pain: n=175) were the most common patterns. Medial knee pain and distally radiating pain were significantly more likely in those with symptomatic knee OA. Individuals with generalised knee pain with radiation had more persistent, severe pain, and a relatively high proportion had moderate or severe radiographic disease.


CONCLUSIONS
No single pattern of pain location is pathognomonic for knee OA. Attention towards the role of peripheral nociception and central sensitisation in producing medial knee pain and distally radiating knee pain is warranted.
Wood
L R J
LR
Keele University, Primary Care Musculoskeletal Research Centre, Keele, United Kingdom. l.r.j.wood@cphc.keele.ac.uk
Peat
G
G
Thomas
E
E
Duncan
R
R
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D010147:Pain Measurement / Q000379:methods*; D011859:Radiography; D012016:Reference Values; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology