Altman listed a variety of criteria for the diagnosis of idiopathic osteoarthritis of the knee. The diagnosis can be made based on clinical data alone. The author is from the University of Miami and Miami Veterans Administration Medical Center.
Patient selection:
(1) presence of knee pain
(2) absence of a condition predisposing to degenerative arthritis (see Table I, page 33)
Parameters:
(1) age in years
(2) duration of morning stiffness in the affected knee joint
(3) crepitus
(4) bony tenderness
(5) bony enlargement
(6) palpable warmth
|
Parameter |
Finding |
Points |
|
age of the patient in years |
<= 50 years |
0 |
|
|
> 50 years |
1 |
|
duration of knee stiffness |
>= 30 minutes |
0 |
|
|
< 30 minutes |
1 |
|
crepitus |
absent |
0 |
|
|
present |
1 |
|
bony tenderness |
absent |
0 |
|
|
present |
1 |
|
bony enlargement |
absent |
0 |
|
|
present |
1 |
|
palpable warmth |
present |
0 |
|
|
absent |
1 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• A score of 3 or more can be used to identify a patient with clinical osteoarthritis.
Performance:
• The sensitivity for 3 of 6 criteria is 92% and the specificity is 75%.
• The sensitivity for 4 of 6 criteria is 84% and the specificity is 89%, which gives a better Youden index.
Specialty: Surgery, orthopedic, Immunology/Rheumatology
ICD-10: ,
