Clinical tools in diagnosis of knee osteoarthritis in primary care

Abstract

Introduction: The knee osteoarthritis (OA), the most common chronic illness, has the potential to compromise the health and quality of life of not only in the patient but also affect family members and is challenging through the need to develop tools for diagnosis. The aim was to assess the applicability of osteoarthritis index WOMAC and 30s Chair Stand Test (30s-CST) in patients with knee osteoarthritis in primary care. Materials and methods: A cross-sectional study was performed according to the disease severity based on functional limitation in the absence of joint prosthesis. There were recruited patients from primary care that fulfilled the ACR classification criteria for knee OA (1991). All subjects completed the Osteoarthritis index WOMAC (Western Ontario McMaster Universities Questionnaire), Visual Analogue Scale (VAS) for pain and performed 30s-CST. Discussion results: In the study were included 36 patients and 30 (83.3%) of which were females. The mean age of the study group (M ± SD) was 58.6±10.3 (range 37 to 65) years and disease duration (M±SD) 5.6±4.0 (range 1-21) years. The pain was present in 94.4% cases; the level of knee pain assessed by VAS (M±SD) was 66.9 ±21.2mm. The WOMAC index, showed a better result on the stiffness scale (1.43±2.46) and the worsted on physical function (M±SD) 33.2±2.54 points. The result from 30s-CST test in the group was 11.4±0.45s. The result of CST didn’t correlate with pain intensity (r = -0.09); meanwhile, we found a strong correlation with physical function (r = 0.7). WOMAC index values from group were moderate influenced by radiographic severity (r = 0.5). The duration of the medical consultation with utilization of these tools was (M±SD) 20.2±3.4 minutes. Conclusion: The results of the test 30s-CST and WOMAC index correlated insignificantly with the severity of radiographic changes. Meantime, we observed trend of increase for test’s screening power along with disease progression. The application of additional tools increases the duration of medical consultation, an option could be implemented some of them in triage room.