Frequency, pattern, and associations of generalized osteoarthritis among Nigerians with knee osteoarthritis



Osteoarthritis (OA) is a common degenerative condition leading to significant pain, functional limitation, and economic loss. Generalized OA (GOA) is associated with greater morbidity and accounts for 5–25% of total OA cases depending on definition used. This paper aims to determine the frequency and pattern of GOA, compare clinical and laboratory parameters of GOA and non-GOA subjects, then identify independent associations of GOA among Nigerians with knee OA.


A cross-sectional study of 180 knee OA patients with knee and generalized OA defined using ACR criteria. Questionnaire administration was followed by physical examination and appropriate radiographs. Data was summarized using tables and figures. Multivariate regression was done to identify independent GOA associations with statistical significance p<0.05. Ethical approval was obtained for the study.


There were 180 participants with mean age 59.7±9.1 years. Twenty-eight patients (15.6%) had GOA of which 26 were female. The hip/knee/spine pattern was the commonest while hand OA was rare. Comparisons showed that GOA patients were significantly older with longer pain duration, higher pain score, more Heberden’s nodes, and greater fatigue. There were no significant differences between both groups in levels of inflammatory markers and other laboratory parameters. Further analysis identified joint stiffness as the only independent association of GOA (OR 3.34, p=0.01).


A 15.6% frequency of GOA was identified among knee OA sufferers with the hip/knee/spine pattern most frequent. Nigerians with GOA are predominantly females with a large joint phenotype. Joint stiffness was the only independent association of GOA observed.

Key Points
Generalized osteoarthritis occurs in 15.6% of Nigerian patients with knee osteoarthritis.
Females are predominantly affected with a large joint phenotype involving the hip/knee/spine.
Joint stiffness is an independent association of generalized osteoarthritis.

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The authors are grateful to Drs. Leticia Okechi, Idongesit Unanam, Daniel Umoren, Utibemfon Paul, Malipeh Undie (Research Assistants) as well as Mr Aniebiet Obot, Mr Victor Abijah, and Mrs Eme Bassey (Laboratory Staff) for their assistance with data collection and laboratory analyses respectively. Dr F Uduma, Mrs M C Ekpo, Mr Nsikan Nyauko, other Staff of Radiology Department, Colleagues from Internal Medicine Department and the Hospital Management are also acknowledged for their assistance with the study.

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All the authors contributed to study conception and design. Material preparation and data collection were done by Akpabio Akpabio, Richard Akintayo, Abubakar Yerima, and Hakeem Olaosebikan. The first draft was written by Akpabio Akpabio, Richard Akintayo, Abubakar Yerima, Ndanyongmong Akpan, and Olufemi Adelowo. Statistical analysis was done by Akpabio Akpabio, Emaediong Akpan-Ekpo, and Udeme Ekrikpo. All the authors commented on previous versions of the manuscript then read and approved the final version.

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Correspondence to Akpabio Akpabio.

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Akpabio, A., Akintayo, R., Yerima, A. et al. Frequency, pattern, and associations of generalized osteoarthritis among Nigerians with knee osteoarthritis. Clin Rheumatol (2021).

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  • Associations
  • Frequency
  • Generalized osteoarthritis
  • Knee osteoarthritis
  • Nigerians