Accepted for publication 14 September 1990 Abstract The defnition and classification of early clinically apparent osteoarthritis both in clinical situations and in epidemiological surveys remains a problem. Few data exist on the between-observer reproducibility of simple clinical methods of detecting hand and knee osteoarthritis in the population and their sensitivity and specificity as compared with radiography. Two observers first studied the reproducibility of a number of clinical signs in 41 middle aged women. Good rates of agreement were found for most of the clinical signs tested (kappa=054-1-0). The more reproducible signs were then tested on a population of 541 women, aged 45-65, drawn from general practice, screening centres, and patients previously attending hospital for nonrheumatic problems. The major clinical signs used had a high specificity (87-99%) and lower sensitivity (20-49%) when compared with radiographs graded on the Keligren and Lawrence scale (2+=positive). When analysis was restricted to symptomatic radiographic osteoarthritis, levels of sensitivity were increased and specificity was lowered. These data show that certain physical signs of osteoarthritis are reproducible and may be used to identify clinical disease. They are not a substitute for radiographs, however, if radiographic change is regarded as the 'gold standard' of diagnosis. As the clinical signs tested seemed specific for osteoarthritis they may be of value in screening populations for clinical disease.
[1]
C. Cooper,et al.
Radiographic assessment of the knee joint in osteoarthritis.
,
1992,
Annals of the rheumatic diseases.
[2]
Je Dacre,et al.
The use of digital image analysis in the assessment of radiographs in osteoarthritis
,
1992
.
[3]
C. Cooper,et al.
Clinical assessment of osteoarthritis of the knee.
,
1990,
Annals of the rheumatic diseases.
[4]
H. Valkenburg,et al.
Do clinical findings associate with radiographic osteoarthritis of the knee?
,
1990,
Annals of the rheumatic diseases.
[5]
P. Dieppe,et al.
Comparison of visual and radiographic detection of bony changes at the knee joint.
,
1990,
BMJ.
[6]
M. Hochberg,et al.
New radiographic grading scales for osteoarthritis of the hand. Reliability for determining prevalence and progression.
,
1989,
Arthritis and rheumatism.
[7]
P. Dieppe,et al.
Osteoarthritis: definitions and criteria.
,
1989,
Annals of the rheumatic diseases.
[8]
J. Fleiss,et al.
Statistical methods for rates and proportions
,
1973
.
[9]
J. Lawrence,et al.
Osteo-Arthrosis: Prevalence in the Population and Relationship between Symptoms and X-ray Changes
,
1966
.
[10]
J. S. Lawrence,et al.
The Epidemiology of Chronic Rheumatism
,
1964
.