Analysis of the connection between pain, disability and a radiological image determining the treatment process

Introduction: The objective of this paper is to analyse the correlation between pain and the degree of disability, and the lesions shown on radiological examination of KOA.

Material and method: The study encompassed 31 female patients (42 knees) aged 51-70 years, with diagnosed idiopathic knee osteoarthritis. Medical history and analysis of previously performed x-ray scans were conducted. The history included questions regarding pain (VAS, WOMAC index) and the maximum marching distance, the presence of oedema and instability as well as disability in everyday life (WOMAC index). The radiological lesions were assessed using the Kellgren and Lawrence Grading Scale. Moreover, the widths of the joint spaces were measured.

Results: The patients’ pain in everyday activities (WOMAC) showed a positive correlation with the presence of osteophytes (r=0.32), and the intensity of the pain on the VAS correlated with the presence of joint osteophytes (r=0.46) and with the elevation of the intercondylar eminence (r=0.32). The other disorders on the x-ray image did not correlate with the pain. Positive correlations were identified between the presence of oedema (r=0.57) and instability (r=0.39), and the presence of lesions in the patellofemoral joint. The patients’ disability in everyday activities (WOMAC) showed a negative correlation with the width of the joint spaces (r<-0.34). However, no correlations were observed between the remaining x-ray lesions and the WOMAC index.

Conclusions: Only a small number of subjects showed a correlation indicating an interdependency between the painful sensations and the degree of disability versus the progression of radiographic lesions. Among the KOA risk factors, it is worth noting the presence of obesity which, in these studies, affected more than half of the female patients.