ArticleThe Journal of rheumatology2016
Interobserver and Intraobserver Reliability of Clinical Assessments in Knee Osteoarthritis.
Article in The Journal of rheumatology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 45 citations in OpenAlex.
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- Baseline loss of knee extension is associated with regional MRI progression in knee osteoarthritis: a retrospective longitudinal cohort study-data from the osteoarthritis initiative.Rheumatology international · 2025Article
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- Osteoarthritis.Nature reviews. Disease primers · 2025Review
- Capsular stem cell function and tissue composition are associated with symptoms and radiographic severity in people with knee osteoarthritis.Therapeutic advances in musculoskeletal disease · 2025Article
- Planned or recent first consultation with the general practitioner for knee complaints: Is it indicative of early-stage knee osteoarthritis?Osteoarthritis and cartilage open · 2024Article
- Preoperative high-intensity strength training combined with balance training can improve early outcomes after total knee arthroplasty.Journal of orthopaedic surgery and research · 2023Article
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- Healthy Ageing and Intellectual Disability study: summary of findings and the protocol for the 10-year follow-up study.BMJ open · 2022Article
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- Clinical outcomes after anterior cruciate ligament injury: panther symposium ACL injury clinical outcomes consensus group.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- Clinical Outcomes After Anterior Cruciate Ligament Injury: Panther Symposium ACL Injury Clinical Outcomes Consensus Group.Orthopaedic journal of sports medicine · 2020Article
- Do Clinical Correlates of Knee Osteoarthritis Predict Outcome of Intraarticular Steroid Injections?The Journal of rheumatology · 2020Article
- Pathological Relationship between Intestinal Flora and Osteoarthritis and Intervention Mechanism of Chinese Medicine.Chinese journal of integrative medicine · 2019Review
- Establishing outcome measures in early knee osteoarthritis.Nature reviews. Rheumatology · 2019Review
- Magnetic resonance imaging of patellofemoral osteoarthritis: intertester reliability and associations with knee pain and function.Clinical rheumatology · 2019Article
- Performance of distinct knee osteoarthritis classification criteria in the ELSA-Brasil musculoskeletal study.Clinical rheumatology · 2019Article
- Concordance between clinical and radiographic evaluations of knee osteoarthritis.Aging clinical and experimental research · 2018Article
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveClinical examination of the knee is subject to measurement error. The aim of this analysis was to determine interobserver and intraobserver reliability of commonly used clinical tests in patients with knee osteoarthritis (OA).
methodsWe studied subjects with symptomatic knee OA who were participants in an open-label clinical trial of intraarticular steroid therapy. Following standardization of the clinical test procedures, 2 clinicians assessed 25 subjects independently at the same visit, and the same clinician assessed 88 subjects over an interval period of 2-10 weeks; in both cases prior to the steroid intervention. Clinical examination included assessment of bony enlargement, crepitus, quadriceps wasting, knee effusion, joint-line and anserine tenderness, and knee range of movement (ROM). Intraclass correlation coefficients (ICC), estimated kappa (κ), weighted kappa (κω), and Bland-Altman plots were used to determine interobserver and intraobserver levels of agreement.
resultsUsing Landis and Koch criteria, interobserver κ scores were moderate for patellofemoral joint (κ = 0.53) and anserine tenderness (κ = 0.48); good for bony enlargement (κ = 0.66), quadriceps wasting (κ = 0.78), crepitus (κ = 0.78), medial tibiofemoral joint tenderness (κ = 0.76), and effusion assessed by ballottement (κ = 0.73) and bulge sign (κω = 0.78); and excellent for lateral tibiofemoral joint tenderness (κ = 1.00), flexion (ICC = 0.97), and extension (ICC = 0.87) ROM. Intraobserver κ scores were moderate for lateral tibiofemoral joint tenderness (κ = 0.60); good for crepitus (κ = 0.78), effusion assessed by ballottement test (κ = 0.77), patellofemoral joint (κ = 0.66), medial tibiofemoral joint (κ = 0.64), and anserine tenderness (κ = 0.73); and excellent for effusion assessed by bulge sign (κω = 0.83), bony enlargement (κ = 0.98), quadriceps wasting (κ = 0.83), flexion (ICC = 0.99), and extension (ICC = 0.96) ROM.
conclusionAmong individuals with symptomatic knee OA, the reliability of clinical examination of the knee was at least good for the majority of clinical signs of knee OA.
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