http://repub.eur.nl/res/aut/13323/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/40098/ 2013-05-01T00:00:00Z Objective Discordance between having pain and radiologic osteoarthritis (OA) is a well-established fact. It is suggested that this particularly applies to the less severe grades of OA. However, some people with a Kellgren/Lawrence (K/L) grade of 3 or 4 for OA are without pain. This study aimed to identify factors and differences in the factors associated with pain in persons with different grades of knee OA. Methods We stratified the knees of more than 5,000 participants of a population-based cohort study, the Rotterdam Study, based on the grade of knee OA. Multivariate generalized estimating equation analysis was used to analyze the association with knee pain. We tested several factors not directly related to structural damage of the knee. Results As expected, an increasing percentage of participants did not report pain with decreasing severity of knee OA: 25.8% for K/L grade 3 or 4 and 84.5% for no knee OA. Being a woman, having widespread pain, reporting general health symptoms, familial OA, and morning stiffness are factors for knee pain, but not specific for a particular grade of radiographic knee OA. Depression and hip OA showed significant interactions with the grade of OA being a factor for knee pain in knees without OA (K/L grade 0), but not in knees with OA. In addition, increasing age is protective for reporting pain in general. Conclusion Several factors are associated with knee pain, but are not specific for a grade of radiographic knee OA. Two factors were associated with knee pain in the knee without signs of OA. Copyright http://repub.eur.nl/res/pub/34932/ 2012-01-01T00:00:00Z Objective. To examine the diagnostic accuracy of hip internal rotation, hip flexion, and knee flexion measurements for the presence of osteophytosis and joint space narrowing (JSN) in early symptomatic osteoarthritis (OA). Methods. The baseline data for 598 participants of the Cohort Hip &Cohort Knee study were used. Participants underwent a standardized physical and radiographic examination. The active range of motion (ROM) was assessed using a goniometer. The ROM cutoff with the highest discriminative ability for radiographic features of OA was defined by maximizing the sum of the sensitivity and specificity. Several diagnostic measures were calculated to establish the diagnostic accuracy of ROM measurements for the presence of radiographic features. Results. In patients with hip symptoms, hip internal rotation <24° and flexion <114° were found to be the cutoffs with the highest discriminative ability to distinguish between patients with and without radiographic features. In patients with knee symptoms, knee flexion <132° was the cutoff with the highest discriminative ability. The American College of Rheumatology (ACR) criterion of hip internal rotation <15° increased the probability of the presence of osteophytosis or JSN from 25% to 58%. The diagnostic accuracy of hip and knee flexion measurements was low. Conclusion. To reduce the number of patients that are not identified by the ACR criterion of hip internal rotation <15°, it is recommended to change the cutoff to internal rotation <24° in patients with early symptomatic OA. Individual hip and knee flexion measurements seem to be of little diagnostic value in early symptomatic OA. http://repub.eur.nl/res/pub/27964/ 2010-03-01T00:00:00Z Study Design: Cross-sectional open population based study (nested in a prospective cohort study). Objective: To explore the association of the different individual radiographic features, including osteophytes and disc space narrowing, with self-reported low back pain (LBP). Different definitions of lumbar disc degeneration with self-reported LBP and disability were considered in a large open population sample. Furthermore, in order to disentangle the discrepancies in reported strength of the associations, we characterized the frequency of the different individual radiographic features of lumbar disc degeneration and definitions of lumbar disc degeneration, as well as their association with LBP status, by age, gender, and vertebral level. Summary of Background Data: Currently within the literature, there have been no studies that have explored different definitions of lumbar disc degeneration and their association with LBP within one study sample. Methods: The intervertebral disc spaces (L1/2 to L5-S1) were evaluated for the presence and severity of anterior osteophytes and disc space narrowing using a semiquantitative score (grade 0-3). Logistic regression was used to determine the association between these individual radiographic features of lumbar disc degeneration and different definitions of lumbar disc degeneration for LBP. Results: Lumbar radiographs were scored for 1204 men, and 1615 women. Osteophytes were the most frequent radiographic feature observed, with men having the greatest frequency. Disc space narrowing was more frequent in women than men. Both radiographic features increased in frequency with age.Disc space narrowing appeared more strongly associated with LBP than osteophytes, especially in men (odds ratio [OR] = 1.9; 95% confidence interval [CI]: 1.4-2.8). Disc space narrowing at 2 or more levels appeared more strongly associated with LBP than disc space narrowing at only 1 level (OR = 2.4; 95% CI: 1.6-3.4). After excluding level L5-S1, the strength of almost all associations increased. Conclusion: We are the first to report different possible lumbar disc degeneration definitions and their associations with LBP. Disc space narrowing at 2 or more levels appeared more strongly associated with LBP than other radiographic features, especially after excluding level L5-S1. http://repub.eur.nl/res/pub/19561/ 2010-01-01T00:00:00Z http://repub.eur.nl/res/pub/29256/ 2008-05-07T00:00:00Z http://repub.eur.nl/res/pub/10393/ 2005-01-01T00:00:00Z This study aimed to assess the incidence of unintentional injuries presented in general practice, and to identify children at risk from experiencing an unintentional injury. We used the data of all 0-17-year-old children from a representative survey in 96 Dutch general practices in 2001. We computed incidence rates and multilevel multivariate regression analysis in different age strata and identified patient and family characteristics associated with an elevated injury risk. Nine thousand four hundred and eighty-four new injury episodes were identified from 105 353 new health problems presented in general practice, giving an overall incidence rate of 115 per 1000 person years (95% confidence interval [CI] = 113 to 118). Sex and residence in rural areas are strong predictors of injury in all age strata. Also, in children aged 0-4 years, a higher number of siblings is associated with elevated injury risk (> or =3 siblings odds ratio [OR] = 1.57, 95% CI = 1.19 to 2.08) and in the 12-17-year-olds, ethnic background and socioeconomic class are associated with experiencing an injury (non-western children OR = 0.67, 95% CI = 0.54 to 0.81; low socioeconomic class OR = 1.39, 95% CI = 1.22 to 1.58). Unintentional injury is a significant health problem in children in general practice, accounting for 9% of all new health problems in children. In all age groups, boys in rural areas are especially at risk to experience an injury.