OARSI initiative to develop classification criteria for early-stage symptomatic knee OA (EsSKOA): What conditions should be considered in the differential diagnosis of EsSKOA?

作者：Gillian Hawker, Lauren King, Jean W. Liew, Qiuke Wang, Armaghan Mahmoudian, Nuria E J Jansen, Ian Stanaitis, Françis Berenbaum, Siddharth Kumar Das, Changhai Ding, Carolyn A. Emery, Stephanie R. Filbay, Marc C. Hochberg, Muneaki Ishijima, M. Kloppenburg, N.E. Lane, Elena Losina, Ali Mobasheri, J. Runhaar, C. Thomas Appleton, Aleksandra Turkiewicz, Martin Englund, Stefan Lohmander, I.K. Haugen, Tuhina Neogi · 发表于：Osteoarthritis and Cartilage · 年份：2025 · DOI：10.1016/j.joca.2025.05.005 · 被引用次数：7 · 研究领域：Osteoarthritis Treatment and Mechanisms、Gout, Hyperuricemia, Uric Acid、Spondyloarthritis Studies and Treatments

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 inj...