Joint damage evaluation in knee osteoarthritis using ultrasonography
Osteoarthritis (OA) is the most common cause of rheumatic disorder and a frequent health problem in the community where symptomatic knee OA has been prevalent in 6% to 10% of the adult population. Traditionally, it has been defined as degenerative changes in bone, cartilage, and soft tissues of the joints. Recently, OA is regarded as a failure of the joint as an organ, much like renal or cardiac failure.
Now, ultrasound is gaining ground over conventional imaging methods in the assessment of musculoskeletal changes in osteoarthritis. Ultrasound has shown to be extremely sensitive in detecting soft tissue changes in knee OA, including synovial proliferation and synovial fluid. A study has compared the ultrasonography (US) with the conventional radiography for assessing joint damage in knee OA.
In a study, a total of 166 knees of 84 patients (59 women and 25 men) with primary knee OA were included. The femoral hyaline cartilage of the medial para-patellar aspect and osteophytes of both medical and lateral femoral condyle were assessed. The US assessment was feature-specifically compared with the conventional radiography.
It was observed that there was a strong correlation between the radiographic medial tibiofemoral narrowing grade and the US medial cartilage grade. In the detailed analysis, US could assess cartilage damage more correctly by using the direct visualization technique. A strong correlation was also found between the radiographic and the US medial femoral osteophyte grade and between the radiographic and the US lateral femoral osteophyte grade. US detected osteophytes in 46 sites at which conventional radiography did not detect any osteophytes.
It was concluded that the trial provides evidence, supporting the concurrent validity of US in assessing the knee joint damage due to OA through its agreement with the conventional radiography. Moreover, US was found to be a sensitive imaging technique for revealing the cartilage damage and even minimal osteophytes, especially in early radiographic stages of knee OA.