Prevalence of generalized osteoarthritis in a population with knee osteoarthritis.

Authors: Forestier R (1) , Françon A (1) , Briole V (2) , Genty C (3) , Chevalier X (4) , Richette P (5)
(1) Centre for Rheumatology and Balneotherapy Research, Aix Les Bains (2) Institut de l’appareil locomoteur Nollet (3) Pôle Santé Publique, TIMC-IMAG UMR 5525, UJF-Grenoble 1 and CNRS, Themas (4) Service de rhumatologie, CHU Henri-Mondor (5) Centre Viggo-Petersen
Source: Joint Bone Spine. 2011 May;78(3):275-8
DOI: 10.1016/j.jbspin.2010.09.024 Publication date: 2011 May E-Publication date: Dec. 30, 2010 Availability: abstract Copyright: © 2009 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.
Language: English Countries: Not specified Location: Not specified Correspondence address: Forestier R :


Article abstract


To determine the prevalence of generalized osteoarthritis in patients with knee osteoarthritis.


Patients with knee osteoarthritis were recruited for a therapeutic trial via press announcement and selected based on American College of Rheumatology radioclinical criteria for femorotibial arthritis. Patients were asked to bring all their radiographs to the study visits, which included a physical examination. Each patient had an inclusion visit and a second visit 1 month later. The study physicians used a standardized chart to indicate clinical and radiographic evidence of osteoarthritis in each patient. At the hands and feet, the presence of clinical criteria was sufficient for the diagnosis of osteoarthritis. The shoulders and elbows were not assessed. Three criteria sets for generalized osteoarthritis were evaluated: Kellgren and Moore criteria (Heberden's nodes or interphalangeal osteoarthritis), ACR criteria (osteoarthritis of the spine and at least two other joints), and Dougados criteria (bilateral finger osteoarthritis or osteoarthritis of the spine and both knees).


We included 302 patients for whom the side affected with knee osteoarthritis was known. Mean symptom duration was 5.9±5.7 years, mean number of painful flares was 10.1±9.4, mean number of joints with osteoarthritis was 2.6±1.8, and mean body mass index was 29.5±5.3 kg/m(2). A family history of osteoarthritis was noted in 154 (51%) patients and spinal osteoarthritis in 148 (49%) patients. Kellgren-Moore criteria for interphalangeal osteoarthritis were met in 42 (13.9%) patients, ACR criteria by 124 (41%) patients, and Dougados criteria by 127 (42%) patients. In all, 156 (52%) patients met at least one of the three definitions of generalized osteoarthritis.


More than half the patients included in a therapeutic trial in knee osteoarthritis had generalized osteoarthritis with maximum symptoms at the knee at baseline. Some patients with osteoarthritis in multiple joints met none of the three criteria sets for generalized osteoarthritis. Further studies are needed to assess the sensitivity and specificity of current criteria sets and, if needed, to identify new criteria.

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