Diagnosing knee osteoarthritis in patients, differences between general practitioners and orthopedic surgeons: a
Bob J Evers1, Henk J Schers2, Cornelia H M van den Ende3
1Radboud Institute for Molecular Life Sciences, Radboud University Medical Centre, Nijmegen, Netherlands. Bob.J.Evers@radboudumc.nl.
BMC Primary Care
|August 1, 2023
Summary
General practitioners underdiagnose osteoarthritis in younger patients (45-54 years), leading to fewer matching diagnoses and potentially delayed knee care. Improving early osteoarthritis recognition in this group is crucial for effective treatment.
Area of Science:
- Orthopedics
- General Practice
- Rheumatology
Background:
- Knee complaints are a common reason for general practitioner (GP) consultations in the Netherlands.
- Unnecessary referrals to orthopedic clinics occur, potentially due to underconsideration of osteoarthritis (OA) by GPs.
- Delayed recognition of OA can impede timely care and lead to suboptimal patient outcomes.
Purpose of the Study:
- To compare the frequency of osteoarthritis diagnosis in GP referral letters versus orthopedic outpatient clinic reports.
- To investigate diagnostic discrepancies for atraumatic knee complaints in patients aged 45 and older.
- To identify potential gaps in the recognition and diagnosis of osteoarthritis by GPs.
Main Methods:
- Retrospective cohort study analyzing referral letters and outpatient clinic reports.
- Data collected from patients with atraumatic knee complaints referred between June 2019 and January 2020.
- Comparison of differential diagnoses by GPs and final diagnoses by orthopedic surgeons.
Main Results:
- Osteoarthritis was less frequently diagnosed in referral letters than in outpatient clinics, particularly in younger patients (45-54 years).
- Matching diagnoses were found in 58.2% of all referrals and 31.6% in the 45-54 age group.
- Significant diagnostic differences (p < 0.001) were observed between GPs and orthopedic surgeons for osteoarthritis and meniscal lesions.
Conclusions:
- Osteoarthritis is underdiagnosed by GPs in younger patients with knee complaints.
- Lower diagnostic agreement in younger age groups highlights a need for improved GP recognition of OA.
- Enhanced diagnostic approaches and targeted education for GPs could improve knee care efficacy.
