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Research ArticleOsteoarthritis

Psychological and Pain Sensitization Characteristics Are Associated With Patellofemoral Osteoarthritis Symptoms: The Multicenter Osteoarthritis Study

Natalie J. Collins, Tuhina Neogi, Bill Vicenzino, Ali Guermazi, Frank W. Roemer, Cora E. Lewis, James C. Torner, Michael C. Nevitt and Joshua J. Stefanik
The Journal of Rheumatology November 2020, 47 (11) 1696-1703; DOI: https://doi.org/10.3899/jrheum.190981
Natalie J. Collins
1N. Collins, PT, PhD, B. Vicenzino, PT, PhD, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia;
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  • ORCID record for Natalie J. Collins
  • For correspondence: n.collins1@uq.edu.au
Tuhina Neogi
2T. Neogi, MD, PhD, A. Guermazi, MD, PhD, School of Medicine, Boston University, Boston Massachusetts, USA;
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  • ORCID record for Tuhina Neogi
Bill Vicenzino
1N. Collins, PT, PhD, B. Vicenzino, PT, PhD, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia;
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Ali Guermazi
2T. Neogi, MD, PhD, A. Guermazi, MD, PhD, School of Medicine, Boston University, Boston Massachusetts, USA;
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Frank W. Roemer
3F.W. Roemer, MD, Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany;
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Cora E. Lewis
4C.E. Lewis, MD, MSPH, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA;
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James C. Torner
5J.C. Torner, PhD, Department of Epidemiology, The University of Iowa, Iowa City, Iowa, USA;
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Michael C. Nevitt
6M.C. Nevitt, MPH, PhD, Department of Epidemiology and Biostatistics, University of California San Francisco, California, USA;
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Joshua J. Stefanik
7J.J. Stefanik, PT, PhD, Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA.
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Abstract

Objective Determine the relation of symptomatic and structural features of patellofemoral osteoarthritis (PFOA) to psychological characteristics and measures of pain sensitization, in older adults with or at risk of knee osteoarthritis (OA).

Methods This study included 1112 participants from the Multicenter Osteoarthritis Study (713 females, mean age 66.8 ± SD 7.6 yrs, body mass index 29.5 ± 4.8 kg/m2). Participants were grouped based on the presence of PFOA symptoms (anterior knee pain and pain on stairs) and magnetic resonance imaging (MRI) PFOA (full-thickness cartilage lesion with bone marrow lesion): (1) patellofemoral (PF) symptoms with MRI PFOA; (2) PF symptoms without MRI PFOA; (3) MRI PFOA without PF symptoms; and (4) no PF symptoms or MRI PFOA (no PFOA). Relation of PFOA classification to depressive symptoms, catastrophizing, temporal summation (TS) and pressure pain thresholds (PPT) was evaluated using logistic (categorical variables) and linear regression (continuous variables).

Results Compared with no PFOA, those with PF symptoms with or without MRI PFOA had significantly greater odds of depressive symptoms, catastrophizing, and patellar TS (OR range 1.5–2.01), and those with PF symptoms without MRI PFOA had significantly greater odds of wrist TS (OR 1.66). Males with PF symptoms without MRI PFOA had significantly lower pressure PPT at the patella compared with no PFOA and those with MRI PFOA only (no symptoms). There were no significant differences at the wrist for males, or the patella or wrist for females.

Conclusion Persons with PFOA symptoms, regardless of MRI PFOA status, are more likely to demonstrate depressive symptoms, catastrophizing, and TS. Males with PFOA symptoms without MRI PFOA demonstrate local hyperalgesia.

Key Indexing Terms:
  • knee
  • magnetic resonance imaging
  • osteoarthritis
  • pain

Footnotes

  • A. Guermazi is the President and shareholder of Boston Imaging Core Lab (BICL), LLC, and consultant to Pfizer, Merck Serono, GE, TissueGene, OrthoTrophix, AstraZeneca, and Sanofi. F. Roemer is a Chief Medical Officer and shareholder of BICL, LLC.

  • The Multicenter Osteoarthritis Study was funded by the National Institutes of Health (NIH; U01-AG18820, U01-AG18832, U01-AG18947, U01-AG19069, and AR-47785). J. Stefanik was supported by NIH/NIGMS U54-GM104941 and K23-AR070913. T. Neogi was supported by K24-AR070892, P60-AR047785, and R01 AR062506. N. Collins was supported by an Arthritis Queensland Fellowship (2018) and The University of Queensland Postdoctoral Fellowship (2015–17).

  • Accepted for publication January 14, 2020.
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1 Nov 2020
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Psychological and Pain Sensitization Characteristics Are Associated With Patellofemoral Osteoarthritis Symptoms: The Multicenter Osteoarthritis Study
Natalie J. Collins, Tuhina Neogi, Bill Vicenzino, Ali Guermazi, Frank W. Roemer, Cora E. Lewis, James C. Torner, Michael C. Nevitt, Joshua J. Stefanik
The Journal of Rheumatology Nov 2020, 47 (11) 1696-1703; DOI: 10.3899/jrheum.190981

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Psychological and Pain Sensitization Characteristics Are Associated With Patellofemoral Osteoarthritis Symptoms: The Multicenter Osteoarthritis Study
Natalie J. Collins, Tuhina Neogi, Bill Vicenzino, Ali Guermazi, Frank W. Roemer, Cora E. Lewis, James C. Torner, Michael C. Nevitt, Joshua J. Stefanik
The Journal of Rheumatology Nov 2020, 47 (11) 1696-1703; DOI: 10.3899/jrheum.190981
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Keywords

KNEE
MAGNETIC RESONANCE IMAGING
OSTEOARTHRITIS
PAIN

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