Effect of non-steroidal anti-inflammatory drugs on dyspeptic symptoms.

Comparison ofradiograph and visual assessment ofone pair of knee joints, showing extensive eburnation (hatched area) and severe osteophytosis (solid lines).Radiograph appears normal and x ray findings was striking.Severe osteophytosis and eburnation were often not visible in x ray films even when these were re-examined with hindsight.The frequency with which osteoarthritis is reported in archaeological material and current figures for the prevalence of the disease3 are often compared.The different sensitivity of the methods used to make a diagnosis, shown by this study, and the fact that palaeopathologists often equate osteophytosis with osteoarthritis4 make such a comparison misleading.In our study 11 of 24 knee joints had osteophytes alone and a further five had other visual changes compatible with osteoarthritis.Thus the prevalence of osteoarthritis could have been reported as 67% or 21% depending on the diagnostic criterion used.Only two of the 24 knee joints were abnormal on radiography, one of which was thought to have changes due to osteoarthritis (4%).Large osteophytes and areas of eburnation, particularly if on the patella groove of the femur or the anteroposterior aspects of the tibio- femoral joint, were often invisible in the radiograph.This suggests that radiography is a poor method of detecting osteoarthritis.It may also partly explain the discrepancy between changes seen in radiographs and symptoms found in epidemiological studies and the difficulties of developing diagnostic criteria for osteo- arthritis of the knee.5 Areas of osteophytosis or focal osteoarthritis may cause symptoms or functional problems but remain invisible to clinicians or radiologists.