RADIOGRAPHIC PATTERNS AND ASSOCIATIONS OF OSTEOARTHRITIS OF THE KNEE IN PATIENTS REFERRED TO HOSPITAL

Objectives-To investigate differing patterns and associations of osteo arthritis of the knee in patients referred to hospital. Methods-Two hu ndred and fifty two consecutive patients (161 women, 91 men; mean age 70 years, range 34-91 years) referred to hospital with osteoarthritis of the knee underwent clinical, radiographic, and synovial fluid scree ning. Results-Radiographic changes of osteoarthritis of the knee (defi nite narrowing with or without osteoarthritic features) were bilateral in 85% of patients. Of 470 knees affected, 277 (59%) were affected in two compartments and 28 (6%) in three compartments. Unilateral and is olated medial tibiofemoral osteoarthritis were more common in men. Cal cium pyrophosphate crystal deposition was common (synovial fluid ident ification in 132 (28%) knees; knee chondrocalcinosis in 76 (30%) patie nts) and associated with disability, bilateral, multicompartmental and severe radiographic osteoarthritis, marked osteophytosis, attrition, and cysts. Multiple clinical nodes (58 (23%) patients) and radiographi c polyarticular interphalangeal osteoarthritis (66 (26%) patients) wer e associated with a higher frequency of inactivity pain, disability, m ulticompartmental and severe radiographic change. Forestier's disease predominated in men but showed no other associations. Conclusions-In a group of patients referred to hospital osteoarthritis of the knee is usually bilateral and affects more than one compartment. Severe and mu lticompartmental radiographic changes are associated with calcium pyro phosphate crystal deposition, nodal change, and polyarticular interpha langeal osteoarthritis.