Performance of Ultrasonography Compared to Conventional Radiography for the Diagnosis of Osteoarthritis in Patients With Knee Pain

Abstract

To investigate the performance of ultrasonography (US) for the detection of knee osteoarthritis (OA) in patients suffering from knee pain, compared to conventional radiographs. Methods: Cross-sectional study performed at a university teaching hospital. Consecutive patients complaining of unilateral or bilateral mechanical knee pain who signed an informed consent were included. All patients underwent simultaneously an ultrasonographic and a radiographic evaluation of the knee. Exclusion criteria were age under 18 years, prior diagnosis of knee OA, diagnosis of inflammatory arthritis, history of knee surgery or trauma, severe knee deformities, and corticosteroid injection within the last 2 months. The diagnostic properties of US for the detection of knee OA were evaluated using radiological data as the reference method. Evaluated test properties were sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the positive and negative likelihood ratio (LR+ and LR-). Results: Three-hundred twenty-two knees (281 patients) were included. Radiographic degenerative changes were present in 56.8% (183) of the evaluated knees. Regarding the diagnostic properties of the US, the presence of either osteophytes or the compromise of the femoral hyaline cartilage had the best sensitivity to detect OA (95%), with a NPV of 92% and a LR-of 0,07, while the combined identification of osteophytes and compromise of the femoral hyaline cartilage had the best specificity (94%), with 94% PPV and a LR+ of 13. Conclusion: US demonstrated an excellent sensitivity with an adequate specificity for the detection of radiographic knee OA.

Role of global femoral cartilage in assessing severity of primary knee osteoarthritis

“…Interestingly, Malas et al in 2014 [33] reported that a positive correlation was discovered between US meniscal extrusion measurements and radiological KL grade. This was also reported by Brom et al [34] concluding that US is a valid method with high sensitivity and specificity for detecting radiographic KOA.…”

The Effectiveness of Traditional Chinese Yijinjing Qigong Exercise for the Patients With Knee Osteoarthritis on the Pain, Dysfunction, and Mood Disorder: A Pilot Randomized Controlled Trial

“…Joint cavity injection therapy is widely used, but the clinical efficacy is still controversial; excessive use of hormones may also lead to the risk of steroid arthropathy (7). Improving symptoms with prevention programmers is key to minimizing the social burden of KOA (8,9). Exercise therapy, as an active treatment recommended by the American Rheumatology Guidelines with strong evidence (10), is increasingly used by clinical staff for the prevention and treatment of KOA.…”

Biological Targets of Multimolecular Therapies in Middle-Age Osteoarthritis

“…In parallel, we must improve imaging interventions based on, for example, clinical biomarkers, such as synovial hypertrophy, joint effusion, and involvement of tendons and ligaments. 78 Finally, to capture relevant changes, early or intermediate outcome measurements should be tailored to the clinical phenotypes of OA. 79…”