Ultrasound properties of articular cartilage in the tibio-femoral joint in knee osteoarthritis: relation to clinical assessment (International Cartilage Repair Society grade)

Abstract

Introduction There is a lack of data relating the macroscopic appearance of cartilage to its ultrasound properties. The purpose of the present study was to evaluate degenerated cartilage and healthy-looking cartilage using an ultrasound system.

The Application of Imaging in Osteoarthritis

“…Effusion and PDS do not appear to be specific for cartlage erosion with effusion also found in 'normal' joints and conflicting results found in current studies (Chao, Wu et al 2010;Kortekaas, Kwok et al 2010;Mancarella, Magnani et al 2010;Wittoek, Carron et al 2010;Wittoek, Jans et al 2010;Arrestier, Rosenberg et al 2011). Subclinical inflammation has been reported in some studies with no correlation found with PDS or patients' reported pain levels but may indicate future disease progression (Kuroki, Nakagawa et al 2008;Kortekaas, Kwok et al 2010;Wittoek, Jans et al 2010). Scanning of the sagittal (longitudinal) extensor and flexor sides is performed in relaxed finger extension with axial imaging used to view the metacarpophalangeal joints and coronal imaging used to view the interphalangeal joints (Koski, Saarakkala et al 2006).…”

“…Specific US findings related to anatomical location of the joint under investigation have also been defined in the literature, with the majority of studies involving the joints of the hand (Walther, Harms et al 2002;Kuroki, Nakagawa et al 2008;Wittoek, Carron et al 2010;Wittoek, Jans et al 2010;Arrestier, Rosenberg et al 2011). Several studies have also investigated the diagnostic accuracy of US compared to CR, CT and MRI in the hand (Keen, Wakefield et al 2008;Moller, Bonel et al 2009;Mancarella, Magnani et al 2010).…”

“…The extensor approach is used to probe the interphalangeal joints as well as the meta-tarsophalangeal joints to detect joint erosions and synovial thickening. In the knee US probes can also be used arthroscopically to assess cartilage morphology as well as conventional scanning protocols to assess cartilage thickness in the weight bearing areas of the femoral condyles, protrusion of the medial meniscus in the knee and the presence of Baker's cysts (Kuroki, Nakagawa et al 2008;Yoon, Kim et al 2008;Iagnocco 2010). Alternative imaging protocols such as the longitudinal sagittal US scan may also provide visualization of a larger area of femoral condyle than the suprapatellar transverse axial scan (Yoon, Kim et al 2008).…”

“…Recent studies have indicated an association between synovial proliferation and BML with pain in OA making their assessment with US particularly attractive (Moller, Bong et al 2008;Kortekaas, Kwok et al 2010). Anatomic sites most frequently assessed with US include the hand, the foot, the knee and hip joints both in terms of primary evaluation of early disease, therapeutic interventions and response to treatment (Walther, Harms et al 2002;Kuroki, Nakagawa et al 2008;Mancarella, Magnani et al 2010). The anatomical site and type of tissue under investigation will determine the US technique used (Moller, Bong et al 2008).…”

Quantitative ultrasound biomicroscopy for the analysis of healthy and repair cartilage tissue

“…In other studies, the maximum magnitude of the reflected ultrasound signals from the surface has been shown to be associated with the modulus or mechanical stiffness of cartilage tissue or with the histological quality of repair tissue Hattori et al, 2004;Kuroki et al, 2008). However, it has to be considered that the "intensity" of the reflected ultrasound signals does not represent an intrinsic material property and may also be influenced by several other factors Zheng et al, 2008).…”