TY - JOUR

T1 - Distinct patterns of variation in the distribution of knee pain

AU - Boudreau, Shellie A.

AU - Royo, Albert Cid

AU - Matthews, Mark

AU - Graven-Nielsen, Thomas

AU - Kamavuako, Ernest N.

AU - Slabaugh, Greg

AU - Thorborg, Kristian

AU - Vicenzino, Bill

AU - Rathleff, Michael Skovdal

PY - 2018

Y1 - 2018

N2 - The patient’s expression of pain using digital-body maps expands analytic opportunities for exploring the spatial variation of bodily pain. A common knee pain condition in adolescents and adults is patellofemoral pain (PFP) and recently PFP was shown to be characterized by a heterogeneous distribution of pain. Whether there are important patterns in these distributions remains unclear. This pioneering study assesses the spatial variation of pain using principal component analysis and a clustering approach. Detailed digital-body maps of knee pain were drawn by 299 PFP patients of mixed sex, age, and pain severity. Three pain distribution patterns emerged resembling an Anchor, Hook, and an Ovate shape on and around the patella. The variations in pain distribution were independent of sex, age, and pain intensity. Bilateral pain associated with a longer duration of pain and the majority characterized by the Hook and Ovate pain distributions. Bilateral and/or symmetrical pain between the left and right knees may represent symptoms associated with longstanding PFP. The distinct patterns of pain location and area suggest specific underlying structures cannot be ruled out as important drivers, although central neuronal mechanisms possibly exemplified by the symmetrical representation of pain may play a role in individuals with longstanding symptoms.

AB - The patient’s expression of pain using digital-body maps expands analytic opportunities for exploring the spatial variation of bodily pain. A common knee pain condition in adolescents and adults is patellofemoral pain (PFP) and recently PFP was shown to be characterized by a heterogeneous distribution of pain. Whether there are important patterns in these distributions remains unclear. This pioneering study assesses the spatial variation of pain using principal component analysis and a clustering approach. Detailed digital-body maps of knee pain were drawn by 299 PFP patients of mixed sex, age, and pain severity. Three pain distribution patterns emerged resembling an Anchor, Hook, and an Ovate shape on and around the patella. The variations in pain distribution were independent of sex, age, and pain intensity. Bilateral pain associated with a longer duration of pain and the majority characterized by the Hook and Ovate pain distributions. Bilateral and/or symmetrical pain between the left and right knees may represent symptoms associated with longstanding PFP. The distinct patterns of pain location and area suggest specific underlying structures cannot be ruled out as important drivers, although central neuronal mechanisms possibly exemplified by the symmetrical representation of pain may play a role in individuals with longstanding symptoms.

U2 - 10.1038/s41598-018-34950-2

DO - 10.1038/s41598-018-34950-2

M3 - Journal article

C2 - 30410031

AN - SCOPUS:85056272662

VL - 8

JO - Scientific Reports

JF - Scientific Reports

SN - 2045-2322

IS - 1

M1 - 16522

ER -