title: Relationship between radiographic changes and symptoms or physical examination findings in subjects with symptomatic medial knee osteoarthritis: a three-year prospective study.
abstract: BACKGROUND
  Although osteoarthritis (OA) of the knee joints is the most common and debilitating joint disease in developed countries, the factors that determine the severity of symptoms are not yet understood well. Subjects with symptomatic medial knee OA were followed up prospectively to explore the relationship between radiographic changes and symptoms or physical examination findings.
  
  
  METHODS
  One-hundred six OA knees in 68 subjects (mean age 71.1 years; 85% women) were followed up at 6-month intervals over 36 months. At each visit, knee radiographs were obtained, symptoms were assessed by a validated questionnaire, and the result of physical examination was recorded systematically using a specific chart. Correlations between the change of radiographs and clinical data were investigated in a longitudinal manner.
  
  
  RESULTS
  During the study period, the narrowing of joint space width (JSW) was observed in 34 joints (32%). Although those knees were clinically or radiographically indistinguishable at baseline from those without JSW narrowing, differences became apparent at later visits during the follow-up. The subjects with knees that underwent JSW narrowing had severer symptoms, and the symptoms tended to be worse for those with higher rates of narrowing. A significant correlation was not found between the severity of symptoms and the growth of osteophytes. For the knees that did not undergo radiographic progression, the range of motion improved during the follow-up period, possibly due to the reduction of knee pain. Such improvement was not observed with the knees that underwent JSW narrowing or osteophyte growth.
  
  
  CONCLUSIONS
  The result of this study indicates that the symptoms of knee OA patients tend to be worse when JSW narrowing is underway. This finding may explain, at least partly, a known dissociation between the radiographic stage of OA and the severity of symptoms.
authors.affiliation: Clinical Research Center, National Hospital Organization Sagamihara Hospital, Sakuradai 18-1, Minami-ku, Kanagawa 252-0315, Japan. n-fukui@sagamihara-hosp.gr.jp
authors.forename: Naoshi
authors.initials: N
authors.lastname: Fukui
authors.forename: Shoji
authors.initials: S
authors.lastname: Yamane
authors.forename: Satoru
authors.initials: S
authors.lastname: Ishida
authors.forename: Konagi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Riako
authors.initials: R
authors.lastname: Masuda
authors.forename: Nobuho
authors.initials: N
authors.lastname: Tanaka
authors.forename: Yozo
authors.initials: Y
authors.lastname: Katsuragawa
authors.forename: Sakiko
authors.initials: S
authors.lastname: Fukui
mesh_terms: D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D054850:Osteophyte / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012720:Severity of Illness Index