Assessment of Neuropathic Pain in Patients with Knee Osteoarthritis
Keywords:
Douleur Neuropathique four questions (DN4), Kellgren and Lawrence grading (KL grading), Osteoarthritis (OA), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)Abstract
ABSTRACT
Objective: To determine the frequency of neuropathic pain in patients with knee joint osteoarthritis.
Study design: A cross sectional study.
Place and duration: Rheumatology clinic from 1st July 2021 till 31st December 2021.
Patients and methods: The study was conducted on 56 patients by using a consecutive non probability sampling technique. Fulfillment of American college of Rheumatology criteria for knee osteoarthritis was the inclusion criteria. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to assess pain, stiffness, and physical functional ability in the knees while the Douleur Neuropathique 4(DN4) questionnaire was used to assess neuropathic pain. Kellgren-Lawrence (KL) grading system was used for radiological classification of knee osteoarthritis.
Results: Out of the 56 patients, 44(78.6%) were female and 12 (21.4%) were male. The mean WOMAC total score in patients with neuropathy was 48.64±10.36. Neuropathic pain was found in 25(44.6%) of the study population. Their mean DN4 questionnaire neuropathy score was 4.64±0.81. p value of 0.02, 0.004, 0.027, 0.003 and 0.01 on the spearman rho correlation was found between the total WOMAC score, radiographic grade, neuropathic pain, WOMAC functional score and WOMAC pain score respectively, showing a significant positive correlation.
Conclusion: There was a high frequency of neuropathic pain in patients with knee osteoarthritis. The DN4 questionnaire score correlated with the WOMAC total score and the functional and pain components. It was also found that the patients with grade I, II and III osteoarthritis (KL grading system) had a significantly higher WOMAC score and DN4 questionnaire score.
