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Journal article
OARSI Initiative to Develop Classification Criteria for Early-Stage Symptomatic Knee OA (EsSKOA): What conditions should be considered in the differential diagnosis of EsSKOA?
Osteoarthritis and cartilage, Vol.33(9), pp.1141-1146
09/2025
PMID: 40414550
Web of Science ID: WOS:001586517200001
Abstract
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.
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.
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).
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.
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- Title
- OARSI Initiative to Develop Classification Criteria for Early-Stage Symptomatic Knee OA (EsSKOA)
- Publication Details
- Osteoarthritis and cartilage, Vol.33(9), pp.1141-1146
- Resource Type
- Journal article
- Publisher
- Elsevier Ltd on behalf of Osteoarthritis Research Society International
- Number of pages
- 6
- Grant note
- Gruenenthal and Viatris Inc.Osteoarthritis Research Society International
We would like to acknowledge the funding support for this initiative by Gruenenthal and Viatris Inc., and the fundraising efforts by Stefan Lohmander, Ali Mobasheri, and Francis Berenbaum, on behalf of the Osteoarthritis Research Society International. We also would like to acknowledge support from the Osteoarthritis Research Society International Board of Directors.
- Copyright
- © 2025 The Author(s)
- Identifiers
- WOS:001586517200001; 99381364062306600
- Academic Unit
- Usha Kundu, MD College of Health; Movement Sciences and Health
- Language
- English