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Correlates of knee pain in younger subjects

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Abstract

The aim of this study was to describe clinical, structural and biochemical factors associated with knee pain in younger subjects. A cross-sectional convenience sample of 371 male and female subjects (mean age, 45 years, range 26–61) was studied. Knee pain was assessed by questionnaire. Chondral defects, cartilage volume, and bone area of the right knee were determined using T1-weighted fat saturation magnetic resonance imaging (MRI). X-ray was performed on the same knee for the assessment of radiographic features of osteoarthritis. The urinary C-terminal cross-linking telopeptide of type II collagen (CTX-II) was measured by enzyme-linked immunosorbent assay (ELISA). Height and weight were measured by standard protocols and body mass index (BMI) was calculated. The prevalence of knee pain was 35% in this sample. Chondral defect scores (particularly femoral and patellar but not tibial) were significantly associated with knee pain in a dose–response fashion (all p<0.01). Cartilage volume and bone area were not associated with knee pain in multivariate analysis in this sample. Urinary CTX-II was higher in subjects with knee pain (p=0.04), but this became nonsignificant after adjustment for BMI and osteophytes (both of which were significant) suggesting potential mechanisms of effect. In conclusion, knee pain is significantly associated with non-full thickness chondral defects (particularly femoral and patellar), osteophytes, CTX-II, and obesity but not other factors. MRI and biochemical measures can add to radiographs in defining unexplained knee pain in younger subjects.

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Acknowledgements

The authors would like to extend their special thanks to the subjects and orthopedic surgeons who made this study possible. The role of C. Boon in coordinating the study is gratefully acknowledged. We would like to thank Dr. Leigh Blizzard for the statistical support, Martin Rush who performed the MRI scans, Kevin Morris and Fabrice Juillet for technical support.

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Authors and Affiliations

  1. Menzies Research Institute, University of Tasmania, Private Bag 23, Hobart, Tasmania, 7001, Australia

    Guangju Zhai, Changhai Ding, Fiona Scott & Graeme Jones

  2. Monash University Medical School, Alfred Hospital, Prahran, Victoria, Australia

    Flavia Cicuttini

  3. INSERM Unit 403, Lyon, France and Molecular Markers, Synarc, Lyon, France

    Patrick Garnero

  4. Twin Research & Genetic Epidemiology Unit, St Thomas’ Hospital, London, UK

    Guangju Zhai

Authors
  1. Guangju Zhai
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  2. Flavia Cicuttini
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  3. Changhai Ding
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  4. Fiona Scott
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  5. Patrick Garnero
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  6. Graeme Jones
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Corresponding author

Correspondence to Graeme Jones.

Additional information

Sources of support. National Health and Medical Research Council of Australia, Masonic Centenary Medical Research Foundation.

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Zhai, G., Cicuttini, F., Ding, C. et al. Correlates of knee pain in younger subjects. Clin Rheumatol 26, 75–80 (2007). https://doi.org/10.1007/s10067-006-0248-8

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  • DOI: https://doi.org/10.1007/s10067-006-0248-8

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