Do non-weight-bearing knee radiographs for chronic knee pain result in increased follow-up imaging?
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SCIENTIFIC ARTICLE
Do non-weight-bearing knee radiographs for chronic knee pain result in increased follow-up imaging? Elizabeth S. Levin 1
&
Jacob C. Mandell 1 & Stacy E. Smith 1,2
Received: 28 April 2020 / Revised: 12 August 2020 / Accepted: 12 August 2020 # ISS 2020
Abstract Objective While weight-bearing radiographs are considered the optimal method for evaluation of joint spaces in osteoarthritis, non-weight-bearing radiographs are often performed. The purpose of this study is to evaluate the rate of follow-up radiographs in patients receiving non-weight-bearing radiographs for chronic knee pain in the outpatient setting, compared with patients receiving weight-bearing radiographs. Materials and methods Consecutive patients who received non-weight-bearing knee radiographs for chronic knee pain between January 1, 2018, and June 15, 2019, were included. Exclusion criteria included trauma, concern for infection or tumor, and postsurgical radiographs. An age- and sex-matched control group of 100 patients who received weight-bearing knee radiographs was compiled. The proportion of follow-up radiographs within 1 year was compared between the study and control groups with chisquared tests. Results Four hundred non-weight-bearing knee radiographic examinations were included. There were 74/400 (18.5%) follow-up radiographs within 12 months. All follow-up radiographs were weight-bearing. In the control group, 4/100 (4%) had follow-up weight-bearing radiographs within 1 year (p < 0.001). Conclusion Outpatients who underwent non-weight-bearing knee radiographs for chronic pain had a higher frequency of repeat imaging than those who initially underwent weight-bearing knee radiographs. These results suggest that non-weight-bearing knee radiographs are of lower clinical utility compared with weight-bearing radiographs. Keywords Knee . Radiography . Non-weight-bearing
Introduction Osteoarthritis is the most common form of arthritis, causing symptoms ranging from mild pain to severe functional limitation and is a significant burden on patients and healthcare systems. Osteoarthritis alone was estimated to cost the United States (US) 80 billion dollars in 2016 [1]. The knee is the most commonly affected joint, with at least 14 million symptomatic adults in the US, and with at least 25% of people
* Elizabeth S. Levin [email protected] 1
Department of Radiology, Division of Musculoskeletal Imaging and Intervention, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA
2
The Neil and Elise Wallace STRATUS Center for Medical Simulation, Brigham and Women’s Hospital, Boston, MA, USA
over age 55 thought to experience at least one episode of knee pain over the course of a year [2–6]. The prevalence of symptomatic knee osteoarthritis increases as risk factors increase, including population aging and obesity [7]. In addition, the number of total knee replacements performed in the US more than doubled from 1999 to 2008, with the greatest rate of growth in people under the age of 60 [8]. Ra
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