Atlas-based knee osteophyte assessment with ultrasonography and radiography: relationship to arthroscopic degeneration of articular cartilage

Koski, J. M.; Kamel, Ahmed; Waris, Pekka; Waris, Ville; Tarkiainen, I.; Karvanen, E.; Szkudlarek, Marcin; Aydin, SZ; Alasaarela, Esko; Schmidt, Wolfgang A.; Miguel, Eugenio de; Mandl, Péter; Filippucci, Emilio; Ziswiler, Hans‐Rudolf; Terslev, Lene; Áts, K; Kurucz, Réka; Naredo, Esperanza; Bálint, Péter; Iagnocco, Annamaria; Lepojärvi, Sannamari; Elseoud, Ahmed Abou; Fouda, Mona A.; Saarakkala, Simo

doi:10.3109/03009742.2015.1055797

Cited by 38 publications

(55 citation statements)

References 15 publications

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“…Cartilage damages identified by US were previously correlated with degenerative cartilage changes found by arthroscopy, but the lack of US findings does not exclude degenerative changes [30]. The association of the hyaline cartilage damageor loss with pain was demonstrated in US and MRI studies [2,13,[31][32][33]. In our study we found that cartilage damage was the most important predictor for knee pain, especially for pain evaluated by VAS.…”

Section: Inter-observer Agreementsupporting

confidence: 54%

“…Of note, the authors did not take into consideration the presence of osteophytes at this level so their results could be biased. Podlipska et al [22], using the scale proposed by Koskiet al [32] for evaluating osteophytes and the distance from bone contour for meniscal protrusion, underlined the added value of US over radiography in knee OA management. One of the drawbacks of the study was that the authors did not correlate these findings with pain.…”

Section: Inter-observer Agreementmentioning

confidence: 99%

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Pain in bilateral knee osteoarthritis – correlations between clinical examination, radiological, and ultrasonographical findings.

et al. 2016

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Aims: The aim of the study was to evaluate the correlations between clinical symptoms (pain), physical examination, ultrasound (US), and radiological findings in patients with bilateral knee osteoarthritis (OA). Material and methods: Knee pain was appreciated during medial and lateral palpation of each knee joint and using visual analogue scale (VAS) and The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). US evaluation (osteophytes, meniscal protrusion, synovial fluid, femoral hyaline cartilage thickness) and radiological assessment (osteophytes, femoral-tibial space, Kellgren-Lawrence [K-L] score, enthesopathies) were performed by two examiners blinded to the clinical results and to each other. All these findings were scored with a five-point scale. Results: A total of 52 consecutive patients aged 63.44±9.49 were examined, 33 (80.5%) being females. In patients with bilateral knee OA the pain, evaluated by WOMAC score and VAS, was correlated with the presence of osteophytes and cartilage thickness but no association with medial meniscal protrusion and effusion was demonstrated. Pain produced by palpation of the knee was strongly associated with the presence of medial osteophytes. VAS and WOMAC scores increased with the severity of radiological and US findings. The presence of osteophytes and articular cartilage damage at US examination were strongly and positively correlated with radiological K-L score. US examiners agreement was good for osteophytes and moderate for meniscal protrusion, cartilage damage, and synovial fluid. The cartilage damage score was the only independent predictor for VAS scale; for WOMAC score the sex, cartilage damage, the presence of medial osteophytes and lateral meniscal protrusion were the independent predictors. Conclusion: Pain intensity was correlated with the severity of US findings, cartilage damage score being an independent predictor for both VAS and WOMAC scores. Medial osteophytes and lateral meniscal protrusion and are independent predictors for WOMAC score.

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Section: Inter-observer Agreementsupporting

confidence: 54%

Section: Inter-observer Agreementmentioning

confidence: 99%

Pain in bilateral knee osteoarthritis – correlations between clinical examination, radiological, and ultrasonographical findings.

et al. 2016

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“…Multivariate linear regression analysis showed that medial inferior osteophytes were not a predictor for VAS score but were a predictor for WOMAC score. One of the limitations of our study is that we only described the presence or absence of osteophytes on the medial and lateral compartments and did not use a semiquantitative assessment as proposed by Koski et al…”

Section: Discussionmentioning

confidence: 99%

Stratifying Minimal Versus Severe Pain in Knee Osteoarthritis Using a Musculoskeletal Ultrasound Protocol

Bernardo‐Bueno

Gonzalez‐Suarez

Malvar

et al. 2018

J of Ultrasound Medicine

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Objective The aim of this cross‐sectional correlational study was to determine the association of pain with morphologic and inflammatory sonographic findings in patients with knee osteoarthritis. Methods A total of 113 participants with knee osteoarthritis were assessed using visual analog scale pain score and sonography. Ultrasound evaluation included morphologic changes (ie, articular cartilage degeneration, medial and lateral meniscal protrusion, and presence of osteophytes on the joint margins) and inflammatory changes (ie suprapatellar effusion and/or synovitis, Baker cyst, superficial and deep infrapatellar effusion, pes anserine tendinopathy, and Hoffa panniculitis). Results Cluster analysis via Ward's method grouped patients with minimal pain (visual analog scale score, 0–4) and with substantial pain (visual analog scale score, 5–10). Stepwise logistic regression yielded 5 variables that significantly explained the variation in the probability of perceived substantial pain at 10% level of significance: lateral cartilage clarity (LCC; P = .025), medial cartilage clarity (MCC; P = .20), medial cartilage thickness (MCT; P = .041), medial meniscus protrusion (MMP) (P = .029), and osteophytes at medial femoral margin (P = .082), with 63% overall prediction accuracy. When age and sex were added, 4 variables remained significant at a 10% level of significance: LCC, MCC, MCT, and MMP, with 65% overall prediction accuracy. The receiver operating characteristic curve of this model was 0.667. Conclusion The study was able to demonstrate that morphologic abnormalities in the ultrasound parameters for LCC, MCC, MCT, and MMP were able to predict significant joint pain in knee osteoarthritis. There were no inflammatory changes that contributed to significant joint pain in this study.

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“…The definitions for osteophyte grades15 assessed from longitudinal images are as follows: Grade 0 – no osteophyte, Grade 1 – small osteophyte, Grade 2 – medium osteophyte, Grade 3 – large osteophyte. In these images, the same grade osteophytes are always present on both femoral (F) and tibial (T) margin.…”

Section: Figurementioning

confidence: 99%

Structure-symptom relationship with wide-area ultrasound scanning of knee osteoarthritis

Podlipská

Koski

Kaukinen

et al. 2017

Sci Rep

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The aetiology of knee pain in osteoarthritis (OA) is heterogeneous and its relationship with structural changes and function is unclear. Our goal was to determine the prevalence of wide-area scanned ultrasound-defined knee OA structural features and their association with pain and functional impairment in 79 symptomatic and 63 asymptomatic subjects. All subjects underwent ultrasound knee wide-area scanning and the severity of articular cartilage degeneration, the presence and size of osteophytes, and meniscal extrusion were evaluated. Subjects filled in a self-administrated questionnaire on present knee pain, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) on clinical symptoms and function over the past week. Cartilage changes were the most prevalent followed by lateral meniscal extrusion, osteophytes and medial meniscal extrusion. The global femoral cartilage grade associated strongly with pain and the WOMAC index. Site-specifically, early medial cartilage changes and thinning in sulcus and lateral site were associated with symptoms. The presence of femoral lateral osteophytes was also associated with both outcomes. Using the novel wide-area ultrasound scanning technique, we were able to confirm the negative impact of femoral cartilage OA changes on clinical symptoms. Presence, not necessarily size, of lateral femoral osteophytes was also associated with increased pain and disability.

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Atlas-based knee osteophyte assessment with ultrasonography and radiography: relationship to arthroscopic degeneration of articular cartilage

Abstract: (2016) Atlas-based knee osteophyte assessment with ultrasonography and radiography: relationship to arthroscopic degeneration of articular cartilage, Scandinavian Journal of Rheumatology, 45:2, 158-164,

Cited by 38 publications

References 15 publications

Pain in bilateral knee osteoarthritis – correlations between clinical examination, radiological, and ultrasonographical findings.

Pain in bilateral knee osteoarthritis – correlations between clinical examination, radiological, and ultrasonographical findings.

Stratifying Minimal Versus Severe Pain in Knee Osteoarthritis Using a Musculoskeletal Ultrasound Protocol

Structure-symptom relationship with wide-area ultrasound scanning of knee osteoarthritis

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