OARSI initiative to develop classification criteria for early-stage symptomatic knee OA (EsSKOA) : What conditions should be considered in the differential diagnosis of EsSKOA?
(2025) In Osteoarthritis and Cartilage 33(9). p.1141-1146- Abstract
Objective: Classification criteria for early-stage symptomatic knee osteoarthritis (EsSKOA) should discriminate individuals with EsSKOA from those with other causes of knee symptoms. We sought to identify conditions in the differential diagnosis of EsSKOA in adults with knee symptoms. Design: We conducted an online survey of clinicians. Those consulting monthly on at least five people with undiagnosed knee symptoms were eligible. From qualitative work and clinical experience, we developed three case scenarios representing possible EsSKOA: 1. 40-year-old with 1 month of knee stiffness and swelling; 2. 50-year-old with 8 months of knee discomfort while walking; and 3. 60-year-old with intense knee discomfort getting out of a car 1 week... (More)
Objective: Classification criteria for early-stage symptomatic knee osteoarthritis (EsSKOA) should discriminate individuals with EsSKOA from those with other causes of knee symptoms. We sought to identify conditions in the differential diagnosis of EsSKOA in adults with knee symptoms. Design: We conducted an online survey of clinicians. Those consulting monthly on at least five people with undiagnosed knee symptoms were eligible. From qualitative work and clinical experience, we developed three case scenarios representing possible EsSKOA: 1. 40-year-old with 1 month of knee stiffness and swelling; 2. 50-year-old with 8 months of knee discomfort while walking; and 3. 60-year-old with intense knee discomfort getting out of a car 1 week ago. For each scenario, participants indicated conditions on a pre-defined list that they would consider in the differential diagnosis, and the top three diagnoses based on clinical experience. The proportions that considered each condition and among the top three diagnoses for each scenario were summarized overall and by clinical discipline. Results: 127 clinicians responded (43% female, 48% in practice ≤15 years, 50% university-affiliated practice, 7 clinical disciplines). Knee OA and meniscal injuries were among the top three conditions in the differential diagnosis for all three scenarios, followed by immune-mediated and crystal-induced inflammatory arthritis (scenario 1), patellofemoral pain syndrome (scenario 2), and collateral ligament injuries (scenario 3). Conclusion: The differential diagnosis for EsSKOA in adults presenting with undiagnosed knee symptoms includes symptomatic established radiographic knee OA, patellofemoral pain syndrome, meniscal and collateral ligament injuries, and immune-mediated and crystal-induced inflammatory arthritis.
(Less)
- author
- Hawker, Gillian A.
; King, Lauren K.
; Liew, Jean W.
; Wang, Qiuke
; Mahmoudian, Armaghan
LU
; Jansen, Nuria E.J.
; Stanaitis, Ian
; Berenbaum, Francis
; Das, Siddharth
; Ding, Changhai
; Emery, Carolyn A.
; Filbay, Stephanie R.
; Hochberg, Marc C.
; Ishijima, Muneaki
; Kloppenburg, Margreet
; Lane, Nancy E.
; Losina, Elena
; Mobasheri, Ali
; Runhaar, Jos
; Appleton, C. Thomas
; Turkiewicz, Aleksandra
LU
; Englund, Martin
LU
; Lohmander, L. Stefan
LU
; Haugen, Ida K.
and Neogi, Tuhina
(Less) - organization
- publishing date
- 2025
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Classification criteria, Diagnosis, Early-stage, Knee osteoarthritis
- in
- Osteoarthritis and Cartilage
- volume
- 33
- issue
- 9
- pages
- 6 pages
- publisher
- W.B. Saunders
- external identifiers
-
- pmid:40414550
- scopus:105006942410
- ISSN
- 1063-4584
- DOI
- 10.1016/j.joca.2025.05.005
- language
- English
- LU publication?
- yes
- id
- 5f7ddc6d-8604-46a1-936d-fdada827ae36
- date added to LUP
- 2025-10-01 12:12:31
- date last changed
- 2025-10-15 14:01:36
@article{5f7ddc6d-8604-46a1-936d-fdada827ae36,
abstract = {{<p>Objective: Classification criteria for early-stage symptomatic knee osteoarthritis (EsSKOA) should discriminate individuals with EsSKOA from those with other causes of knee symptoms. We sought to identify conditions in the differential diagnosis of EsSKOA in adults with knee symptoms. Design: We conducted an online survey of clinicians. Those consulting monthly on at least five people with undiagnosed knee symptoms were eligible. From qualitative work and clinical experience, we developed three case scenarios representing possible EsSKOA: 1. 40-year-old with 1 month of knee stiffness and swelling; 2. 50-year-old with 8 months of knee discomfort while walking; and 3. 60-year-old with intense knee discomfort getting out of a car 1 week ago. For each scenario, participants indicated conditions on a pre-defined list that they would consider in the differential diagnosis, and the top three diagnoses based on clinical experience. The proportions that considered each condition and among the top three diagnoses for each scenario were summarized overall and by clinical discipline. Results: 127 clinicians responded (43% female, 48% in practice ≤15 years, 50% university-affiliated practice, 7 clinical disciplines). Knee OA and meniscal injuries were among the top three conditions in the differential diagnosis for all three scenarios, followed by immune-mediated and crystal-induced inflammatory arthritis (scenario 1), patellofemoral pain syndrome (scenario 2), and collateral ligament injuries (scenario 3). Conclusion: The differential diagnosis for EsSKOA in adults presenting with undiagnosed knee symptoms includes symptomatic established radiographic knee OA, patellofemoral pain syndrome, meniscal and collateral ligament injuries, and immune-mediated and crystal-induced inflammatory arthritis.</p>}},
author = {{Hawker, Gillian A. and King, Lauren K. and Liew, Jean W. and Wang, Qiuke and Mahmoudian, Armaghan and Jansen, Nuria E.J. and Stanaitis, Ian and Berenbaum, Francis and Das, Siddharth and Ding, Changhai and Emery, Carolyn A. and Filbay, Stephanie R. and Hochberg, Marc C. and Ishijima, Muneaki and Kloppenburg, Margreet and Lane, Nancy E. and Losina, Elena and Mobasheri, Ali and Runhaar, Jos and Appleton, C. Thomas and Turkiewicz, Aleksandra and Englund, Martin and Lohmander, L. Stefan and Haugen, Ida K. and Neogi, Tuhina}},
issn = {{1063-4584}},
keywords = {{Classification criteria; Diagnosis; Early-stage; Knee osteoarthritis}},
language = {{eng}},
number = {{9}},
pages = {{1141--1146}},
publisher = {{W.B. Saunders}},
series = {{Osteoarthritis and Cartilage}},
title = {{OARSI initiative to develop classification criteria for early-stage symptomatic knee OA (EsSKOA) : What conditions should be considered in the differential diagnosis of EsSKOA?}},
url = {{http://dx.doi.org/10.1016/j.joca.2025.05.005}},
doi = {{10.1016/j.joca.2025.05.005}},
volume = {{33}},
year = {{2025}},
}