The Association Between Gonarthrosis Pain Severity and Radiographic Findings on X-Ray: A Cross-Sectional Study.

INTRODUCTION: Knee osteoarthritis (KOA) is a degenerative joint disease that progresses over time due to articular cartilage loss. Orthopedic surgeons use plain radiography (X-ray) with an anteroposterior (AP) standing (weight-bearing) view, which is currently considered the gold standard modality, to diagnose KOA. They base this diagnosis on the clinical history and physical examination of the knee joint. However, many previous studies have reported a weak correlation between knee-joint structural abnormalities on X-rays and described pain. Therefore, our study aimed to assess the incompatibility between patients' pain-severity complaints and radiographic findings on standing AP view. No similar study has been recently published in the Middle East. METHODS: 158 participants were selected for the study from King Abdulaziz University Hospital, Jeddah, between March 2022 and August 2022. We graded the patients' AP knee radiographs using the Kellgren-Lawrence (KL) grading scale and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, by which we made phone calls to assess pain severity on a 0-10 pain subscale. RESULTS: We found a significant association between the 0-10 pain subscale and WOMAC questions describing difficulty in sitting (p < 0.05). Comparing KL scores on X-ray on a 0-10 pain subscale, we found a significant association between mild pain and severe radiological findings on X-ray and vice versa. In addition, the comparison between KL scores on X-ray and WOMAC questions describing difficulty in sitting showed a significant association between moderate difficulty in sitting and severe radiological findings and vice versa. CONCLUSION: Our results indicated that there was a significant relationship between mild pain and severe radiological findings on X-rays and vice versa. Additionally, there was a significant relationship, based on the KL score and the WOMAC item that assessed sitting difficulty, between moderate sitting difficulty and severe radiological findings and vice versa. This may suggest that central and peripheral sensitization could be one factor in the causes of pain.

Determination of lumbosacral transitional vertebrae in kidney urinary bladder x-ray films in the Saudi population.

OBJECTIVES: To investigated the rate of occurrence of lumbosacral transitional vertebrae (LSTV), spinal variant, in kidney urinary bladder (KUB) plain radiographs in a Saudi population.  Methods: Between January 2012 to January 2015, KUB plain films obtained from patients at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, were reviewed, and the presence or absence of LSTV was documented and classified as incomplete or complete. Patients who had evidence of spinal surgery that would obscure the view were excluded.  Results: A total of 2078 patients underwent KUB examinations during the study period; LSTV anomalies were detected in 158 of these. Sacralization was present in 153 (96.8%) of this cohort, while lumbarization was present in 5 (3.2%). A total of 136 (86.1%) of the sacralized segments were of the incomplete type, whereas 17 (10.7%) were complete. Of the lumbarized vertebrae, 3 (1.8%) were incomplete, and 2 (1.2%) were complete. The most frequent type in men was type Ib (28.5%) for sacralized segments, and type IIb for lumbarized segments (0.6%). In women, type Ia was the most common form of sacralized segments (11.3%) and type IIb was the most common form of lumbarized segments (2.8%). Conclusion: The prevalence of LSTV in Saudi patients is 7.6%, with a higher incidence of sacralization than lumbarization. Further studies with larger sample sizes and longer follow-up time are needed to demonstrate the clinical significance thereof.

A preliminary exploration of ulnar variance in healthy wrists at a tertiary hospital in Jeddah.

OBJECTIVES: To gain preliminary insight by exploring ulnar variance changes in a Saudi-based sample.   METHODS: This 6-month (December 2013 to June 2014) cross-sectional study was conducted on a randomly selected healthy adult volunteers with a sample size of 104, at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Posteroanterior (PA), anteroposterior (AP), and PA grip views are taken. The variables of interest were the PA, AP, and PA fist measurements of both right and left wrists. An independent t-test was used to compare means between groups. RESULTS: A total of 104 volunteers were recruited. Among 17 participants who had a negative ulnar variance on right PA views, a significantly high proportion (n=9; 56.2%) maintained a negative value on fist views; 7 participants (43.8%) had a neutral ulnar variance while none (0%) had a positive value (p less than 0.001). Similarly, a significant proportion of participants who had neutral, or positive values on right PA views maintained the same values on right fist views (p less than 0.001). On radiographs of the right wrist, the ulnar variance decreased with a change in wrist position, with an absolute difference in magnitude of 2.13 (p less than 0.001) between PA and AP views. Similarly, the ulnar variance on the left side decreased significantly between PA and AP views (absolute difference in magnitude, 1.68; p less than 0.001).   CONCLUSIONS: Ulnar variance changes in our sample are similar to what is reported in the literature.