A prospective study of relationship between medial joint pain and mild knee osteoarthritis

Brajesh Dadarya, Ashish Sirsikar, Ashok Vidyarthi


Background: The relationship between joint pain and osteoarthritis is poorly understood, however, the most common patterns associated with knee osteoarthritis are diffuse or medial joint pain. The objective of the study was to test the sensitivity of medial knee joint pain for the diagnosis of mild knee osteoarthritis, and thence its relationship.

Methods: This is a prospective analytical study of 124 patients visiting to our out-patient setup in the year 2017, with complaint of medial knee joint pain, which after thorough clinical examination, were investigated radiologically.

Results: In our study of 124 patients, there were 69 female (55.5%) and 55 male (47.5%), with a mean age of 59.3 years. The average duration of symptoms was 3.2 years, and the average VAS for severity of pain was 59.3. The sensitivity of medial knee joint pain for mild OA was thus calculated to be 79.8%.

Conclusions: Medial knee joint pain is a very important symptom to raise a suspicion and also to warrant further radiological investigation for the early diagnosis and management of knee OA.


Knee osteoarthritis, Medial knee pain, Pain location

Full Text:



Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. The Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Development of criteria for the classification and reporting of osteoarthritis: classification of osteoarthritis of the knee. Arthritis Rheum. 1986;29:1039–49.

Felson DT. The epidemiology of knee osteoarthritis: results from the Framingham Osteoarthritis Study. Semin Arthritis Rheum. 1990;20:42-50.

Thompson LR, Boudreau R, Hannon MJ, Newman AB, Chu CR, Jansen M, et al. The knee pain map: reliability of a method to identify knee pain location and pattern. Arthritis Rheum. 2009;61:725-31.

Thompson LR, Boudreau R, Newman AB, Hannon MJ, Chu CR, Nevitt MC, et al. The association of osteoarthritis risk factors with localized, regional and diffuse knee pain. Osteoarthritis Cartilage. 2010;18:1244-9.

Creamer P, Hochberg MC. Why does osteoarthritis of the knee hurt—sometimes? Br J Rheumatol. 1997;37:726–8.

Hochman JR, Gagliese L, Davis AM, Hawker GA. Neuropathic pain symptoms in a community knee OA cohort. Osteoarthritis Cartilage. 2011;19:647-54.

Bennell KL, Kyriakides M, Metcalf B, Egerton T, Wrigley TV, Hodges PW, et al. Neuromuscular versus quadriceps strengthening exercise in people with medial kneeosteoarthritis and varus malalignment: a randomized controlled trial. Arthritis Rheum. 2014;66:950-9.

Bennell KL, Hunt MA, Wrigley TV, Hunter DJ, McManus FJ, Hodges PW, et al. Hip strengthening reduces symptoms but not knee load in people with medial knee osteoarthritis and varus malalignment: a randomised controlled trial. Osteoarthritis Cartilage. 2010;18:621-8.

Pham T, Maillefert JF, Hudry C, Kieffert P, Bourgeois P, Lechevalier D, et al. Laterally elevated wedged insoles in the treatment of medial knee osteoarthritis. A two-year prospective randomized controlled study. Osteoarthritis Cartilage. 2004;12:46-55.

Ayral X, Pickering EH, Woodworth TG, Mackillop N, Dougados M. Synovitis: a potential predictive factor of structural progression of medial tibiofemoral knee osteoarthritis - results of a 1 year longitudinal arthroscopic study in 422 patients. Osteoarthritis Cartilage. 2005;13:361-7.

Wise BL, Niu J, Yang M, Lane NE, Harvey W, Felson DT, et al. Patterns of compartment involvement in tibiofemoral osteoarthritis in men and women and in whites and African Americans. Arthritis Care Res (Hoboken). 2012;64:847-52.

Van Ginckel A, Bennell KL, Campbell PK, Wringley TV, Hunter DJ, et al. Location of knee pain in medial knee osteoarthritis: patterns and associations with self-reported clinical symptoms. Osteoarthritis Cartilage. 2016;24:1135-42.

Wood LR, Peat G, Thomas E, Duncan R. Knee osteoarthritis in community-dwelling older adults: are there characteristic patterns of pain location? Osteoarthritis Cartilage. 2007;15:615-23.

Dixon AStJ. Progress in clinical rheumatology. London: Churchill; 1965: 313–329.

Cicuttini FM, Baker J, Hart D, Spector TD. Association of pain with radiological changes in different compartments and views of the knee joint. Osteoarthritis Cart. 1996;4:143–7.

Lethbridge-Cejku M, Scott WW Jr, Reichle R, Ettinger WH, Zonderman A, Costa P, et al. Association of radiographic features of osteoarthritis of the knee with knee pain: data from the Baltimore Longitudinal Study of Aging. Arthritis Care Res. 1995;8:182–8.

Spector TD, Hart DJ, Byrne J, Harris PA, Dacre JE, Doyle DV. Definition of osteoarthritis for epidemiological studies. Ann Rheum Dis. 1993;52:70–4.