title: Association between radiographic features of knee osteoarthritis and pain: results from two cohort studies.
abstract: OBJECTIVE
  To examine the relation of radiographic features of osteoarthritis to knee pain in people with knees discordant for knee pain in two cohorts.
  
  
  METHODS
  Within person, knee matched, case-control study.
  
  
  METHODS
  Participants in the Multicenter Osteoarthritis (MOST) and Framingham Osteoarthritis studies who had knee radiographs and assessments of knee pain.
  
  
  METHODS
  Association of each pain measure (frequency, consistency, and severity) with radiographic osteoarthritis, as assessed by Kellgren and Lawrence grade (0-4) and osteophyte and joint space narrowing grades (0-3) among matched sets of two knees within individual participants whose knees were discordant for pain status.
  
  
  RESULTS
  696 people from MOST and 336 people from Framingham were included. Kellgren and Lawrence grades were strongly associated with frequent knee pain-for example, for Kellgren and Lawrence grade 4 v grade 0 the odds ratio for pain was 151 (95% confidence interval 43 to 526) in MOST and 73 (16 to 331) in Framingham (both P<0.001 for trend). Similar results were also seen for the relation of Kellgren and Lawrence scores to consistency and severity of knee pain. Joint space narrowing was more strongly associated with each pain measure than were osteophytes.
  
  
  CONCLUSIONS
  Using a method that minimises between person confounding, this study found that radiographic osteoarthritis and individual radiographic features of osteoarthritis were strongly associated with knee pain.
authors.affiliation: Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, 650 Albany Street, Boston, MA 02118, USA. tneogi@bu.edu
authors.forename: Tuhina
authors.initials: T
authors.lastname: Neogi
authors.forename: David
authors.initials: D
authors.lastname: Felson
authors.forename: Jingbo
authors.initials: J
authors.lastname: Niu
authors.forename: Michael
authors.initials: M
authors.lastname: Nevitt
authors.forename: Cora E
authors.initials: CE
authors.lastname: Lewis
authors.forename: Piran
authors.initials: P
authors.lastname: Aliabadi
authors.forename: Burt
authors.initials: B
authors.lastname: Sack
authors.forename: James
authors.initials: J
authors.lastname: Torner
authors.forename: Lawrence
authors.initials: L
authors.lastname: Bradley
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D010147:Pain Measurement; D011379:Prognosis; D011859:Radiography
references.citation: Pain. 1990 Aug;42(2):183-195
references.pmid: 2247316
references.citation: Am J Public Health. 1994 Mar;84(3):351-8
references.pmid: 8129049
references.citation: Arthritis Rheum. 2006 Aug;54(8):2488-95
references.pmid: 16868968
references.citation: J Rheumatol. 1988 Dec;15(12):1833-40
references.pmid: 3068365
references.citation: Arthritis Care Res. 1995 Sep;8(3):182-8
references.pmid: 7654803
references.citation: J Rheumatol. 1992 Dec;19(12):1943-9
references.pmid: 1294744
references.citation: Proc Natl Acad Sci U S A. 1999 Jul 6;96(14):7744-51
references.pmid: 10393892
references.citation: Ann Intern Med. 2007 Oct 16;147(8):534-40
references.pmid: 17938391
references.citation: Arthritis Rheum. 2005 Nov;52(11):3542-7
references.pmid: 16255043
references.citation: Pain. 2006 Sep;124(1-2):126-33
references.pmid: 16701952
references.citation: Ann Epidemiol. 1995 Jul;5(4):297-302
references.pmid: 8520712
references.citation: Clin J Pain. 1995 Sep;11(3):189-93
references.pmid: 8535037
references.citation: J Rheumatol Suppl. 2004 Apr;70:50-3
references.pmid: 15132355
references.citation: Pain. 2002 Oct;99(3):443-452
references.pmid: 12406519
references.citation: Pain. 2003 Nov;106(1-2):19-25
references.pmid: 14581106
references.citation: Semin Arthritis Rheum. 1989 May;18(4 Suppl 2):4-9
references.pmid: 2786254
references.citation: Ann Intern Med. 1992 Apr 1;116(7):598-9
references.pmid: 1543316
references.citation: Arthritis Rheum. 2007 Sep;56(9):2986-92
references.pmid: 17763427
references.citation: N Engl J Med. 2008 Sep 11;359(11):1108-15
references.pmid: 18784100
references.citation: J Rheumatol Suppl. 2004 Apr;70:54-60
references.pmid: 15132356
references.citation: Arthritis Rheum. 1988 Feb;31(2):204-9
references.pmid: 3348824
references.citation: J Rheumatol. 2000 Jun;27(6):1513-7
references.pmid: 10852280
references.citation: Ann Rheum Dis. 1996 Dec;55(12):931-3
references.pmid: 9014590
references.citation: J Rheumatol. 1991 Oct;18(10):1581-6
references.pmid: 1765985
references.citation: Pain. 2003 Nov;106(1-2):101-8
references.pmid: 14581116
references.citation: Arthritis Rheum. 1987 Aug;30(8):914-8
references.pmid: 3632732
references.citation: Novartis Found Symp. 2004;260:64-74; discussion 74-8, 100-4, 277-9
references.pmid: 15283444
references.citation: Pain. 2005 Jun;115(3):225-226
references.pmid: 15911149
references.citation: Am J Epidemiol. 2008 Jul 1;168(1):89-97
references.pmid: 18477651
references.citation: Prog Brain Res. 2000;122:245-53
references.pmid: 10737063
references.citation: J Rheumatol. 1999 Aug;26(8):1785-92
references.pmid: 10451078
references.citation: J Rheumatol. 2008 Oct;35(10):2047-54
references.pmid: 18793000
references.citation: Ann Rheum Dis. 2007 Jan;66(1):86-91
references.pmid: 16877532
references.citation: Science. 2001 Jul 13;293(5528):311-5
references.pmid: 11452128
references.citation: Osteoarthritis Cartilage. 2008 Apr;16(4):415-22
references.pmid: 18296075
references.citation: Ann Rheum Dis. 1993 Nov;52(11):790-4
references.pmid: 8250610
references.citation: Ann Rheum Dis. 1966 Jan;25(1):1-24
references.pmid: 5905334
references.citation: Ann Rheum Dis. 1998 Oct;57(10):595-601
references.pmid: 9893570