Can radiographic patellofemoral osteoarthritis be diagnosed using clinical assessments?
Corresponding Author
Jade M. Tan
Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
Correspondence
Jade M Tan, Discipline of Podiatry and La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia.
Email: jade.tan@latrobe.edu.au
Search for more papers by this authorHylton B. Menz
Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
Search for more papers by this authorShannon E. Munteanu
Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
Search for more papers by this authorNatalie J. Collins
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
Search for more papers by this authorHarvi F. Hart
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
Department of Physical Therapy, Faculty of Health Sciences, Collaborative Training Program in Musculoskeletal Health Research, and Bone and Joint Institute, The University of Western Ontario, London, Canada
Search for more papers by this authorJoel W. Donnar
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
Search for more papers by this authorGearoid Cleary
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
Search for more papers by this authorIsobel C. O'Sullivan
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
Search for more papers by this authorLiam R. Maclachlan
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
Search for more papers by this authorCatherine L. Derham
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
Search for more papers by this authorKay M. Crossley
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
Search for more papers by this authorCorresponding Author
Jade M. Tan
Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
Correspondence
Jade M Tan, Discipline of Podiatry and La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia.
Email: jade.tan@latrobe.edu.au
Search for more papers by this authorHylton B. Menz
Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
Search for more papers by this authorShannon E. Munteanu
Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
Search for more papers by this authorNatalie J. Collins
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
Search for more papers by this authorHarvi F. Hart
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
Department of Physical Therapy, Faculty of Health Sciences, Collaborative Training Program in Musculoskeletal Health Research, and Bone and Joint Institute, The University of Western Ontario, London, Canada
Search for more papers by this authorJoel W. Donnar
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
Search for more papers by this authorGearoid Cleary
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
Search for more papers by this authorIsobel C. O'Sullivan
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
Search for more papers by this authorLiam R. Maclachlan
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
Search for more papers by this authorCatherine L. Derham
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
Search for more papers by this authorKay M. Crossley
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
Search for more papers by this authorAbstract
Introduction
The aim of this study was to determine whether participant characteristics and clinical assessments could identify radiographic osteoarthritis (OA) in individuals with clinically diagnosed, symptomatic patellofemoral osteoarthritis (PFOA).
Methods
Participant characteristics and clinical assessments were obtained from 179 individuals aged 50 years and over with clinically diagnosed symptomatic PFOA, who were enrolled in a randomised trial. Anteroposterior, lateral, and skyline X-rays were taken of the symptomatic knee. The presence of radiographic PFOA was defined as “no or early PFOA” (Kellgren and Lawrence [KL] grade ≤1 in the PF compartment) or “definite PFOA” (KL grade ≥2). Diagnostic test statistics were applied to ascertain which participant characteristics and clinical assessments could identify the presence of definite radiographic PFOA.
Results
A total of 118 participants (66%) had definite radiographic PFOA. Univariate analysis identified that older age (>61 years), female sex, higher body mass index (BMI) (>29 kg/m2), longer pain duration (>2.75 years), higher maximum knee pain during stair ambulation (>47/100 mm), and fewer repeated single step-ups to pain onset (<21) were associated with the presence of definite radiographic PFOA. Multivariate logistic regression indicated that BMI, pain duration, and repeated single step-ups to pain onset were independently associated with radiographic PFOA and identified the presence of definite radiographic PFOA with an overall accuracy of 73%.
Conclusion
In individuals over 50 years of age with a clinical diagnosis of PFOA, higher BMI, longer pain duration, and fewer repeated single step-ups to pain onset increased the likelihood of radiographic PFOA. However, overall diagnostic accuracy was modest, suggesting that radiographic PFOA cannot be confidently identified using these tests.
CONFLICT OF INTEREST
None of the authors have a competing interest to declare.
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