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Kiso T, Okada Y, Kawata S, Shichiji K, Okumura E, Hatsumi N, Matsuura R, Kaminaga M, Kuwano H, Okumura E. Diagnostic accuracy of a novel ultrasound imaging index for knee osteoarthritis: Evaluation of sensitivity, specificity, and predictive values. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:687-699. [PMID: 38608151 DOI: 10.1002/jcu.23691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 04/03/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024]
Abstract
PURPOSE We aimed to develop and validate a new ultrasonography (US) index for the diagnosis of primary medial-type knee osteoarthritis (OA). METHODS In total, 156 patients (203 limbs) underwent standing knee radiography and the US for suspected knee OA. Total osteophyte height (TOH) and distance between bones (DBB) aided diagnosis. Logistic regression identified optimal cutoff values. Thresholds from logistic regression informed recipient operating characteristic curve (ROC) analysis, balancing sensitivity and specificity. These thresholds were then applied in the differential thermal analysis (DTA) to construct a 2 × 2 table. RESULTS The TOH-DBB index showed that a DBB of 5.6 mm or less was required to diagnose primary medial-type knee arthropathy. The results in the 2 × 2 table were 41 true-positive (TP), 10 false negative (FN), 22 true-negative (TN), and 7 false positive (FP). A DBB of 5.6 mm or less and TOH of 4.7 mm or more were necessary to diagnose severe deformity. The results in the 2 × 2 table were 10 TP, 4 FN, 23 TN, and 4 FP. CONCLUSION The TOH-DBB index was confirmed to capture changes in primary medial-type knee OA across various stages.
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Affiliation(s)
- Takeharu Kiso
- Department of Radiology, Medical Corporation Seireikai Tachikawa Memorial Hospital, Kasama, Ibaraki, Japan
- Graduate School of Medicine, Suzuka University of Medical Science, Suzuka-shi, Mie, Japan
| | - Yukinori Okada
- Department of Radiation Oncology, St. Marianna University School of Medicine, Kawasaki-shi, Kanagawa, Japan
| | - Satoru Kawata
- Department of Radiology, Faculty of Medical and Health Sciences, Tsukuba International University, Tsuchiura-shi, Ibaraki, Japan
- Postdoctoral Program, Graduate School of Health Sciences, Kyorin University, Mitaka-shi, Tokyo, Japan
| | - Kouta Shichiji
- Department of Radiology, Medical Corporation Seireikai Tachikawa Memorial Hospital, Kasama, Ibaraki, Japan
| | - Eiichiro Okumura
- Department of Radiology, Faculty of Medical and Health Sciences, Tsukuba International University, Tsuchiura-shi, Ibaraki, Japan
| | - Noritaka Hatsumi
- Department of Radiology, Medical Corporation Seireikai Tachikawa Memorial Hospital, Kasama, Ibaraki, Japan
| | - Ryohei Matsuura
- Department of Radiology, Medical Corporation Seireikai Tachikawa Memorial Hospital, Kasama, Ibaraki, Japan
| | - Masaki Kaminaga
- Department of Radiology, Medical Corporation Seireikai Tachikawa Memorial Hospital, Kasama, Ibaraki, Japan
| | - Hikaru Kuwano
- Department of Radiology, Medical Corporation Seireikai Tachikawa Memorial Hospital, Kasama, Ibaraki, Japan
| | - Erika Okumura
- Department of Radiology, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan
- Master of Medical Science, Graduate School of Medical Science, Suzuka University of Medical Science, Suzuka-shi, Mie, Japan
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Okada S, Taniguchi M, Yagi M, Motomura Y, Okada S, Nakazato K, Fukumoto Y, Kobayashi M, Kanemitsu K, Ichihashi N. Characteristics of Acute Cartilage Response After Mechanical Loading in Patients with Early-Mild Knee Osteoarthritis. Ann Biomed Eng 2024; 52:1326-1334. [PMID: 38329562 DOI: 10.1007/s10439-024-03456-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/17/2024] [Indexed: 02/09/2024]
Abstract
This study determined whether the acute cartilage response, assessed by cartilage thickness and echo intensity, differs between patients with early-mild knee osteoarthritis (OA) and healthy controls. We recruited 56 women aged ≥ 50 years with Kellgren-Lawrence (KL) grade ≤ 2 (age, 70.6 ± 7.4 years; height, 153.7 ± 5.2 cm; weight, 51.9 ± 8.2 kg). Based on KL grades and knee symptoms, the participants were classified into control (KL ≤ 1, asymptomatic, n = 27) and early-mild knee OA groups (KL 1 and symptomatic, KL 2, n = 29). Medial femoral cartilage thickness and echo intensity were assessed using ultrasonographic B-mode images before and after treadmill walking (15 min, 3.3 km/h). To investigate the acute cartilage response, repeated-measures analysis of covariance (groups × time) with adjusted age, external knee moment impulse, steps during treadmill walking, and cartilage thickness at pre-walking was performed. A significant interaction was found at the tibiofemoral joint; after walking, the cartilage thickness was significantly decreased in the early-mild knee OA group compared to the control group (p = 0.002). At the patellofemoral joint, a significant main effect of time was observed, but no interaction was detected (p = 0.802). No changes in cartilage echo intensity at either the tibiofemoral or patellofemoral joints, and no interactions were noted (p = 0.295 and p = 0.063). As acute cartilage response after walking, the thickness of the medial tibiofemoral joint in the early-mild knee OA was significantly reduced than that in the control group. Thus, greater acute deformation after walking might be a feature found in patients with early-mild knee OA.
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Affiliation(s)
- Shogo Okada
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
- Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan
| | - Masashi Taniguchi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Masahide Yagi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yoshiki Motomura
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
- Kobayashi Orthopaedic Clinic, Kyoto, Japan
| | - Sayaka Okada
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kaede Nakazato
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yoshihiro Fukumoto
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| | | | | | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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Ivanov I, Ranchev S, Stoychev S. Experimental Ultrasound Approach for Studying Knee Intra-Articular Femur-Tibia Movements under Different Loads. J Funct Morphol Kinesiol 2023; 9:8. [PMID: 38249085 PMCID: PMC10801608 DOI: 10.3390/jfmk9010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 01/23/2024] Open
Abstract
The purpose of the present study was to develop an experimental model for the study of intra-articular knee movements depending on the function of the knee joint and involved muscle groups under isometric stretching conditions with different loads. The experimental procedure included an ultrasound examination of a knee joint after isometric stretching in healthy men (n = 32). The changes (in millimeters) in the distances between the femur and tibia were measured using an ultrasound sonographer at three stages. The first stage was performed on ten (n = 10) healthy men in five different sitting and upright positions. In the second and third experimental model stages, lower limbs loading was applied to 22 participants. Our hypothesis, which was confirmed, was that as a result of increased loads on the participant's back, an intra-articular decrease in the femur-tibia cartilage surface distance would be observed. The accuracy of the created experimental model was improved over its three stages from 30% to 9%. Quantitative model data can help to create a mathematical model of the mechanical effects during the deformation of knee joint bone cartilage and it can also help outline some future tasks: increasing loading weights, enlarging participant groups, performing comparisons of men and women, and performing comparisons of healthy and pathological individuals.
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Affiliation(s)
- Ivan Ivanov
- National Sports Academy “Vassil Levski”, 1700 Sofia, Bulgaria
- Institute of Mechanics, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria; (S.R.); (S.S.)
| | - Sergey Ranchev
- Institute of Mechanics, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria; (S.R.); (S.S.)
| | - Stoyan Stoychev
- Institute of Mechanics, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria; (S.R.); (S.S.)
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Nevalainen MT, Uusimaa AP, Saarakkala S. The ultrasound assessment of osteoarthritis: the current status. Skeletal Radiol 2023; 52:2271-2282. [PMID: 37060461 PMCID: PMC10509065 DOI: 10.1007/s00256-023-04342-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/17/2023] [Accepted: 04/10/2023] [Indexed: 04/16/2023]
Abstract
Traditionally, osteoarthritis (OA) is diagnosed with the clinical examination supplemented by the conventional radiography (CR). In the research literature, the role of ultrasound (US) imaging in the diagnostics of OA has risen steadily during the last two decades. US imaging is cheap and globally widely available often already in primary healthcare. Here, we reviewed the most essential US literature focusing on OA diagnostics and progression prediction using the various search engines. Starting from the year 2000, our search provided 1 445 journal articles. After reviewing the abstracts, 89 articles were finally included. Most of the reviewed articles focused on the imaging of knee and hand OA, whereas only a minority dealt with the imaging of hip, ankle, midfoot, acromioclavicular, and temporomandibular joints. Overall, during the last 20 years, the use of US imaging for OA assessment has increased in the scientific literature. In knee and hand joints, US imaging has been reported to be a promising tool to evaluate OA changes. Furthermore, the reproducibility of US as well as its association to MRI findings are excellent. Importantly, US seems to even outperform CR in certain aspects, such as detection of osteophytes, joint inflammation, meniscus protrusion, and localized cartilage damage (especially at the medial femoral condyle and sulcus area). Based on the reviewed literature, US can be truly considered as a complementary tool to CR in the clinical setup for OA diagnostics. New technical developments may even enhance the diagnostic value of the US in the future.
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Affiliation(s)
- Mika T Nevalainen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, POB 5000, FI-90014, Oulu, Finland.
- Department of Diagnostic Radiology, Oulu University Hospital, P.O. Box 50, 90029, Oulu, Finland.
| | - Antti-Pekka Uusimaa
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, POB 5000, FI-90014, Oulu, Finland
| | - Simo Saarakkala
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, POB 5000, FI-90014, Oulu, Finland
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Okada S, Taniguchi M, Yagi M, Motomura Y, Okada S, Fukumoto Y, Kobayashi M, Kanemitsu K, Ichihashi N. Ultrasonographic echo intensity in the medial femoral cartilage is enhanced prior to cartilage thinning in women with early mild knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2023; 31:3964-3970. [PMID: 37140655 DOI: 10.1007/s00167-023-07440-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 04/23/2023] [Indexed: 05/05/2023]
Abstract
PURPOSE We aimed to determine whether altered cartilage echo intensity is associated with knee osteoarthritis (OA) severity and whether the alteration occurs before thinning of the femoral cartilage in knee OA. METHODS The medial femoral cartilage thickness and echo intensity of 118 women aged ≥ 50 years were assessed using an ultrasound imaging device. Based on the Kellgren-Lawrence (KL) grade and knee symptoms, participants were classified into five groups: control (asymptomatic grades 0-1), early OA (symptomatic grade 1), grade 2, grade 3, and grade 4. Analysis of covariance, with adjusted age and height, and the Sidak post hoc test were used to assess the differences in cartilage thickness and echo intensity in knees with varying OA severity. RESULTS The echo intensity on longitudinal images, equivalent to the tibiofemoral weight-bearing surface, was significantly higher in the grade 2 group than that in the control group (p = 0.049). However, no significant difference was noted in cartilage thickness (n.s.). In the grades 3 and 4 groups, cartilage thickness became thinner as OA progressed (p < 0.001 and p < 0.001, respectively). However, the cartilage echo intensity was not significantly enhanced compared with that of the grade 2 group (n.s.). There were no significant differences in the cartilage thickness and echo intensity between the early OA and control groups on the longitudinal images (n.s.). CONCLUSIONS The echo intensity of the medial femoral cartilage was high in patients with KL grade 2, without decreased thickness. Our findings suggested that higher echo intensity is a feature of early cartilage degeneration in mild knee OA. Further studies are needed to establish this feature as a useful screening parameter of early cartilage degeneration in knee OA. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Shogo Okada
- A Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Masashi Taniguchi
- A Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan.
| | - Masahide Yagi
- A Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Yoshiki Motomura
- A Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
- Kobayashi Hospital, 50-35 Kuzetakada-Cho, Minami-Ku, Kyoto, 601-8211, Japan
| | - Sayaka Okada
- A Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Yoshihiro Fukumoto
- A Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
- Faculty of Rehabilitation, Kansai Medical University, 18-89 Uyamahigashicho, Hirakata, Osaka, 573-1136, Japan
| | - Masashi Kobayashi
- Kobayashi Hospital, 50-35 Kuzetakada-Cho, Minami-Ku, Kyoto, 601-8211, Japan
| | - Kyoseki Kanemitsu
- Kanemitsu Clinic, 33-2 Enmamae-Cho, Kamigyo-Ku, Kyoto, 602-8307, Japan
| | - Noriaki Ichihashi
- A Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
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Ogura T, Katagiri T, Kameda H. Cartilage evaluation by ultrasonography in patients with rheumatoid arthritis: a scoping review. Inflamm Regen 2023; 43:34. [PMID: 37403142 DOI: 10.1186/s41232-023-00286-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/20/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND This study aimed to provide an overview of ultrasonographic cartilage evaluation in patients with rheumatoid arthritis (RA) and identify research gaps in the utilization of cartilage evaluation. METHODS The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. A systematic literature search of the PubMed, Embase, and Cochrane Library databases was conducted for articles published up to July 2022 using the search term variations of "cartilage," "ultrasonography," and "rheumatoid arthritis." Studies that included patients with RA who underwent cartilage evaluation by ultrasonography were selected. Articles published in languages other than English and about juvenile idiopathic arthritis were excluded. RESULTS Twenty-nine articles were identified. Most were cross-sectional studies (86%), mainly involving the metacarpophalangeal (55%) and knee (34%) joints. Assessments were performed using quantitative, binary, and semi-quantitative methods in 15, 10, and 15 studies, respectively. Reliability assessments were conducted in 10 studies, which showed feasible reliability but were limited to the finger joints. The validity assessment was validated in one study each that compared cartilage thickness measurements with cadaveric specimens and histological and semi-quantitative methods with surgical specimens, respectively. Comparisons with conventional radiography were also performed in six studies, which showed significant correlations. However, there was heterogeneity in the examination and assessment methods, and no adequate longitudinal evaluation was conducted. CONCLUSION This review highlights the need for further research and validation of ultrasonographic cartilage assessment in patients with RA.
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Affiliation(s)
- Takehisa Ogura
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Toho University, 2-22-36, Ohashi, Meguro-Ku, Tokyo, 153-8515, Japan.
| | - Takaharu Katagiri
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Toho University, 2-22-36, Ohashi, Meguro-Ku, Tokyo, 153-8515, Japan
| | - Hideto Kameda
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Toho University, 2-22-36, Ohashi, Meguro-Ku, Tokyo, 153-8515, Japan
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Liu B, Xu HY, Zhang R, Han L, Li Y, Sun XF. An Update on Clinical Utility of Musculoskeletal Ultrasonography in Knee Osteoarthritis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:1413-1422. [PMID: 36715025 DOI: 10.1002/jum.16176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/27/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
In knee osteoarthritis (KOA), timely and accurate assessment of the severity is essential to help orthopedic surgeons determine the most appropriate therapeutic strategies and evaluate disease outcomes and responses for corresponding treatments. In KOA, musculoskeletal ultrasonography (MSUS) could effectively help detect various abnormalities, including synovitis, osteophytes, and cartilage damage. Further, MSUS could be used to monitor the response to different therapies in KOA, to guide local diagnostic and therapeutic procedures. In the future, applications based on continuously evolving US tools could enhance the clinical utility of MSUS in KOA.
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Affiliation(s)
- Bo Liu
- Department of Cadre's Wards Ultrasound Diagnostics,Ultrasound Diagnostic Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Hui-Ying Xu
- Department of Cadre's Wards Ultrasound Diagnostics,Ultrasound Diagnostic Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Rui Zhang
- Department of Cadre's Wards Ultrasound Diagnostics,Ultrasound Diagnostic Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Lu Han
- Department of Cadre's Wards Ultrasound Diagnostics,Ultrasound Diagnostic Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yang Li
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xiao-Feng Sun
- Department of Cadre's Wards Ultrasound Diagnostics,Ultrasound Diagnostic Center, The First Hospital of Jilin University, Changchun, Jilin, China
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Relationship between individual forces of each quadriceps head during low-load knee extension and cartilage thickness and knee pain in women with knee osteoarthritis. Clin Biomech (Bristol, Avon) 2022; 91:105546. [PMID: 34920238 DOI: 10.1016/j.clinbiomech.2021.105546] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 11/11/2021] [Accepted: 12/07/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study aimed to clarify the individual forces of each quadriceps head during low-load contractions and to determine the associations between individual muscle force and cartilage thickness and symptoms in female knee osteoarthritis patients. METHODS Twenty-two women with painful knee osteoarthritis and 15 asymptomatic age-matched women (control group) participated in this cross-sectional study. Maximal knee extension strength and the cross-sectional area of each quadriceps muscle were measured. Shear modulus was calculated for each muscle during 20-Nm torque production by shear-wave elastography. Muscle force index was defined as the product of the cross-sectional area and shear modulus. Medial femur cartilage thickness was measured using an ultrasound B-mode image. Knee pain during gait was evaluated using a Numerical Rating Scale. Muscle force index, cross-sectional area, and maximal knee extension strength, which were defined as muscle functions, were compared between groups using the unpaired t-test. Correlation coefficients were calculated using muscle function, cartilage thickness, or pain. FINDINGS Maximal strength and vastus lateralis force index were smaller in the knee osteoarthritis group than in the control group (p < 0.001 and p = 0.005, respectively). In the knee osteoarthritis group, vastus medialis and vastus lateralis force indexes were positively correlated with cartilage thickness (r = 0.57 and r = 0.45, respectively), whereas the rectus femoris force index was negatively correlated with cartilage thickness (r = -0.45). The vastus lateralis force index was negatively correlated with knee pain (ρ = -0.56). INTERPRETATION Vasti force indices were positively associated with cartilage thickness; however, rectus femoris index was negatively associated in female patients with knee osteoarthritis.
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Ultrasonographic Assessment of the Normal Femoral Articular Cartilage of the Knee Joint: Comparison with 3D MRI. ScientificWorldJournal 2021; 2021:9978819. [PMID: 34456636 PMCID: PMC8387170 DOI: 10.1155/2021/9978819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 08/10/2021] [Indexed: 11/17/2022] Open
Abstract
Objective Ultrasonography (US) has a promising role in evaluating the knee joint, but capability to visualize the femoral articular cartilage needs systematic evaluation. We measured the extent of this acoustic window by comparing standardized US images with the corresponding MRI views of the femoral cartilage. Design Ten healthy volunteers without knee pathology underwent systematic US and MRI evaluation of both knees. The femoral cartilage was assessed on the oblique transverse axial plane with US and with 3D MRI. The acoustic window on US was compared to the corresponding views of the femoral sulcus and both condyles on MRI. The mean imaging coverage of the femoral cartilage and the cartilage thickness measurements on US and MRI were compared. Results Mean imaging coverage of the cartilage of the medial femoral condyle was 66% (range 54%-80%) and on the lateral femoral condyle 37% (range 25%-51%) compared with MRI. Mean cartilage thickness measurement in the femoral sulcus was 3.17 mm with US and 3.61 mm with MRI (14.0% difference). The corresponding measurements in the medial femoral condyle were 1.95 mm with US and 2.35 mm with MRI (21.0% difference), and in the lateral femoral condyle, they were 2.17 mm and 2.73 mm (25.6% difference), respectively. Conclusion Two-thirds of the articular cartilage of the medial femoral condyle, and one-third in the lateral femoral condyle, can be assessed with US. The cartilage thickness measurements seem to be underestimated by US. These results show promise for the evaluation of the weight-bearing cartilage of the medial femoral condyle with US.
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Vendries V, Ungi T, Harry J, Kunz M, Podlipská J, MacKenzie L, Venne G. Three-dimensional ultrasound for knee osteophyte depiction: a comparative study to computed tomography. Int J Comput Assist Radiol Surg 2021; 16:1749-1759. [PMID: 34313914 PMCID: PMC8580923 DOI: 10.1007/s11548-021-02456-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 07/06/2021] [Indexed: 11/29/2022]
Abstract
Purpose Osteophytes are common radiographic markers of osteoarthritis. However, they are not accurately depicted using conventional imaging, thus hampering surgical interventions that rely on pre-operative images. Studies have shown that ultrasound (US) is promising at detecting osteophytes and monitoring the progression of osteoarthritis. Furthermore, three-dimensional (3D) ultrasound reconstructions may offer a means to quantify osteophytes. The purpose of this study was to compare the accuracy of osteophyte depiction in the knee joint between 3D US and conventional computed tomography (CT). Methods Eleven human cadaveric knees were pre-screened for the presence of osteophytes. Three osteoarthritic knees were selected, and then, 3D US and CT images were obtained, segmented, and digitally reconstructed in 3D. After dissection, high-resolution structured light scanner (SLS) images of the joint surfaces were obtained. Surface matching and root mean square (RMS) error analyses of surface distances were performed to assess the accuracy of each modality in capturing osteophytes. The RMS errors were compared between 3D US, CT and SLS models. Results Average RMS error comparisons for 3D US versus SLS and CT versus SLS models were 0.87 mm ± 0.33 mm (average ± standard deviation) and 0.95 mm ± 0.32 mm, respectively. No statistical difference was found between 3D US and CT. Comparative observations of imaging modalities suggested that 3D US better depicted osteophytes with cartilage and fibrocartilage tissue characteristics compared to CT. Conclusion Using 3D US can improve the depiction of osteophytes with a cartilaginous portion compared to CT. It can also provide useful information about the presence and extent of osteophytes. Whilst algorithm improvements for automatic segmentation and registration of US are needed to provide a more robust investigation of osteophyte depiction accuracy, this investigation puts forward the potential application for 3D US in routine diagnostic evaluations and pre-operative planning of osteoarthritis.
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Affiliation(s)
- Valeria Vendries
- Anatomical Sciences Program and Department of Biomedical and Molecular Sciences, Queens University, Kingston, ON, K7L3 N6, Canada.
| | - Tamas Ungi
- School of Computing, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Jordan Harry
- Anatomical Sciences Program and Department of Biomedical and Molecular Sciences, Queens University, Kingston, ON, K7L3 N6, Canada
| | - Manuela Kunz
- School of Computing, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Jana Podlipská
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Les MacKenzie
- Anatomical Sciences Program and Department of Biomedical and Molecular Sciences, Queens University, Kingston, ON, K7L3 N6, Canada
| | - Gabriel Venne
- Department of Anatomy and Cell Biology, McGill University, Montreal, QC, H3A 0G4, Canada
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Comparison of ultrasonographic, radiographic and intra-operative findings in severe hip osteoarthritis. Sci Rep 2020; 10:21108. [PMID: 33273686 PMCID: PMC7713233 DOI: 10.1038/s41598-020-78235-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 11/17/2020] [Indexed: 11/09/2022] Open
Abstract
Aim of this study was to assess the US findings of patients with late-stage hip OA undergoing total hip arthroplasty (THA), and to associate the US findings with conventional radiography (CR) and intraoperative findings. Moreover, the inter-rater reliability of hip US, and association between the US and Oxford Hip Score (OHS) were evaluated. Sixty-eight hips were included, and intraoperative findings were available on 48 hips. Mean patient age was 67.6 years and 38% were males. OA findings-osteophytes at femoral collum and anterosuperior acetabulum, femoral head deformity and effusion-were assessed on US, CR and THA. The diagnostic performance of US and CR was compared by applying the THA findings as the gold standard. Osteoarthritic US findings were very common, but no association between the US findings and OHS was observed. The pooled inter-rater reliability (n = 65) varied from moderate to excellent (k = 0.538-0.815). When THA findings were used as the gold standard, US detected femoral collum osteophytes with 95% sensitivity, 0% specificity, 81% accuracy, and 85% positive predictive value. Concerning acetabular osteophytes, the respective values were 96%, 0%, 88% and 91%. For the femoral head deformity, they were 92%, 36%, 38% and 83%, and for the effusion 49%, 85%, 58% and 90%, respectively. US provides similar detection of osteophytes as does CR. On femoral head deformity, performance of the US is superior to CR. The inter-rater reliability of the US evaluation varies from moderate to excellent, and no association between US and OHS was observed in this patient cohort.
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Abstract
PURPOSE OF REVIEW This narrative review summarizes the last 5 years of published, peer-reviewed research on the use of musculoskeletal ultrasound (US) in osteoarthritis (OA). RECENT FINDINGS Multiple features relevant to OA can be visualized on US, including synovitis, erosion, enthesitis, osteophytes, cartilage damage, meniscal extrusion, and popliteal cysts. US can be used to confirm a diagnosis of OA or make an alternate diagnosis in the clinical setting. When a standardized protocol is used, US is a reliable modality for assessment of the features of OA. Findings on US can predict progression and response to therapy in OA of the hand and knee and can allow characterization of risk factors in a cost-effective, non-invasive, repeatable manner. US is becoming more widely used in OA imaging and has clear value in addition to radiography and clinical assessment. US will likely prove useful in defining phenotypes and providing treatment guidance in OA.
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Affiliation(s)
- Amanda E Nelson
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Doc J. Thurston Building, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA.
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13
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Yerich NV, Alvarez C, Schwartz TA, Savage-Guin S, Renner JB, Bakewell CJ, Kohler MJ, Lin J, Samuels J, Nelson AE. A Standardized, Pragmatic Approach to Knee Ultrasound for Clinical Research in Osteoarthritis: The Johnston County Osteoarthritis Project. ACR Open Rheumatol 2020; 2:438-448. [PMID: 32597564 PMCID: PMC7368135 DOI: 10.1002/acr2.11159] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 05/21/2020] [Indexed: 11/05/2022] Open
Abstract
Objective This study sought to develop and employ a comprehensive and standardized ultrasound (US) protocol and scoring atlas for the evaluation of features relevant to knee osteoarthritis (KOA) in a community‐based cohort in the United States, with the goals of demonstrating feasibility, reliability, and validity. Methods We utilized data from the fourth follow‐up (2016‐2018) of the Johnston County OA Project, which includes individuals with (~50%) and without radiographic KOA. All participants underwent standardized knee radiography and completed standard questionnaires including the Knee Injury and Osteoarthritis Outcome Score (KOOS). Bilateral knee US images were obtained by a trained sonographer using a standardized protocol and scored by trained rheumatologists using an atlas developed for this study. A total of 396 knees were each scored by two readers according to the atlas. Associations between US features, radiographic findings (graded by an expert radiologist), and KOOS scores were assessed. Results Overall interreader reliability for US scoring was fair to moderate. The strongest correlations between US and radiographic features were seen for osteophytes, and similarly strong correlations were seen between US osteophytes and overall radiographic Kellgren‐Lawrence Grade, demonstrating criterion validity. Features of effusion/synovitis and osteophytes were most associated with KOOS pain and impaired function. Conclusion US is a feasible, reliable, and valid method to assess features relevant to KOA in clinical and research settings. The protocol and atlas developed in this study can be utilized to evaluate KOA in a standardized fashion in future clinical studies, enabling greater utilization of this valuable modality in osteoarthritis.
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Affiliation(s)
| | | | | | | | | | | | | | - Janice Lin
- Stanford Health Care, Palo Alto, California
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14
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Sakellariou G, Scirè CA, Adinolfi A, Batticciotto A, Bortoluzzi A, Delle Sedie A, De Lucia O, Dejaco C, Epis OM, Filippucci E, Idolazzi L, Picchianti Diamanti A, Zabotti A, Iagnocco A, Filippou G. Differential Diagnosis of Inflammatory Arthropathies by Musculoskeletal Ultrasonography: A Systematic Literature Review. Front Med (Lausanne) 2020; 7:141. [PMID: 32457913 PMCID: PMC7221062 DOI: 10.3389/fmed.2020.00141] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/31/2020] [Indexed: 12/27/2022] Open
Abstract
Background: Differential diagnosis in early arthritis is challenging, especially early after symptom onset. Several studies applied musculoskeletal ultrasound in this setting, however, its role in helping diagnosis has yet to be clearly defined. The purpose of this work is to systematically assess the diagnostic applications of ultrasonography in early arthritis in order to summarize the available evidence and highlight possible gaps in knowledge. Methods: In December 2017, existing systematic literature reviews (SLR) on rheumatoid arthritis (RA), osteoarthritis (OA), psoriatic arthritis (PsA), polymyalgia rheumatica (PMR), calcium pyrophosphate deposition disease (CPPD), and gout were retrieved. Studies on ultrasound to diagnose the target conditions and detecting elementary lesions (such as synovitis, tenosynovitis, enthesitis, bone erosions, osteophytes) were extracted from the SLRs. The searches of the previous reviews were updated and data from new studies fulfilling the inclusion criteria extracted. Groups of reviewers worked separately for each disease, when possible diagnostic accuracy (sensitivities, specificities) was calculated from primary studies. When available, the reliability of ultrasound to detect elementary lesions was extracted. Results: For all the examined disease, recent SLRs were available. The new searches identified 27 eligible articles, with 87 articles included from the previous SLRs. The diagnostic performance of ultrasound in identifying diseases was addressed by 75 studies; in most of them, a single elementary lesion was used to define diagnosis, except for PMR. Only studies on RA included consecutive patients with new onset of arthritis, while studies on gout and CPPD often focused on subjects with mono-arthritis. Most of the remaining studies enrolled patients with a defined diagnosis. Synovitis was the most frequently detected lesion; clinical diagnosis was the most common reference standard. The diagnostic performance of ultrasound across different conditions was extremely variable. Ultrasound to identify elementary lesions was assessed in 38 studies in OA, gout and CPPD. Its performance in OA was very variable, with better results in CPPD and gout. The reliability of ultrasound was moderate to good for most lesions. Conclusions: Although a consistent amount of literature investigated the diagnostic application of ultrasound, in only a minority of cases its additional value over clinical diagnosis was tested. This SLR underlines the need for studies with a pragmatic design to identify the placement of ultrasound in the diagnostic pathway of new-onset arthritis.
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Affiliation(s)
- Garifallia Sakellariou
- Division of Rheumatology, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Carlo Alberto Scirè
- UOC e Sezione di Reumatologia - Dipartimento di Scienze Mediche, Università degli Studi di Ferrara, Ferrara, Italy.,Società Italiana di Reumatologia, Unità Epidemiologica, Milan, Italy
| | | | - Alberto Batticciotto
- Rheumatology Unit, Department of Internal Medicine, ASST-Settelaghi, "Ospedale di Circolo - Fondazione Macchi", Varese, Italy
| | - Alessandra Bortoluzzi
- UOC e Sezione di Reumatologia - Dipartimento di Scienze Mediche, Università degli Studi di Ferrara, Ferrara, Italy
| | | | - Orazio De Lucia
- Unit of Clinical Rheumatology, Department of Rheumatology and Clinical Sciences, ASST Centro Traumatologico Ortopedico G. Pini - CTO, Milan, Italy
| | - Christian Dejaco
- Department of Rheumatology, Medical University of Graz, Graz, Austria.,Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy
| | | | - Emilio Filippucci
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Carlo Urbani Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Luca Idolazzi
- Rheumatology Unit, Ospedale Civile Maggiore, University of Verona, Verona, Italy
| | - Andrea Picchianti Diamanti
- Department of Clinical and Molecular Medicine, S. Andrea University Hospital, "Sapienza" University, Rome, Italy
| | - Alen Zabotti
- Department of Medical and Biological Science, Rheumatology Clinic, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - Annamaria Iagnocco
- Academic Rheumatology Centre, Università degli Studi di Torino, Turin, Italy
| | - Georgios Filippou
- UOC e Sezione di Reumatologia - Dipartimento di Scienze Mediche, Università degli Studi di Ferrara, Ferrara, Italy
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15
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Kauppinen K, Pylväläinen J, Pamilo K, Helminen O, Haapea M, Saarakkala SS, Nevalainen MT. Association between grayscale sonographic and clinical findings in severe knee osteoarthritis. JOURNAL OF CLINICAL ULTRASOUND : JCU 2020; 48:75-81. [PMID: 31580500 DOI: 10.1002/jcu.22779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 08/31/2019] [Accepted: 09/06/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE To assess whether ultrasonographic (US) findings associate with clinical findings in severe knee osteoarthritis (OA). Association of US findings with side-of-knee pain and inter-reader agreement of knee US were also evaluated. METHODS One-hundred-two patients (in total 123 knees) with severe knee OA were recruited for this cross-sectional study. US was performed by a single observer, and on 53 knees by two independent observers to assess inter-reader reliability. Preoperative clinical data was available for 69 knees. Cutoff values were applied to dichotomize US and clinical findings. The Chi-square test, Mann-Whitney test, and prevalence- and bias-adjusted kappa (PABAK) were applied for statistical analyses. RESULTS Seven of 99 associations tested were statistically significant. Associations were observed between range of flexion and lateral femoral (P = .009) and tibial (P = .001) osteophytes, mediolateral instability and damage to the lateral femoral cartilage (P = .014) and damage to the lateral meniscus (P = .031), and alignment and damage to the lateral femoral cartilage (P < .001), lateral tibial osteophytes (P = .037), and damage to the lateral meniscus (P < .001). A strong association was observed between medial-sided pain and same-sided cartilage damage and osteophytes (P < .001). That inter-reader agreement was excellent on the medial side of the knee joint (PABAK = 0.811-0.887). CONCLUSIONS US findings show a rather poor association with clinical OA findings. Inter-reader agreement of knee US is excellent on the medial side.
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Affiliation(s)
- Kyösti Kauppinen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Juho Pylväläinen
- Department of Radiology, Helsinki University Hospital, Helsinki, Finland
- Department of Radiology, Central Finland Central Hospital, Jyväskylä, Finland
| | - Konsta Pamilo
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
| | - Olli Helminen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
| | - Marianne Haapea
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Simo S Saarakkala
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Mika T Nevalainen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Radiology, Central Finland Central Hospital, Jyväskylä, Finland
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
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16
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Mobasheri A, Saarakkala S, Finnilä M, Karsdal MA, Bay-Jensen AC, van Spil WE. Recent advances in understanding the phenotypes of osteoarthritis. F1000Res 2019; 8. [PMID: 31885861 PMCID: PMC6913225 DOI: 10.12688/f1000research.20575.1] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2019] [Indexed: 01/15/2023] Open
Abstract
Recent research in the field of osteoarthritis (OA) has focused on understanding the underlying molecular and clinical phenotypes of the disease. This narrative review article focuses on recent advances in our understanding of the phenotypes of OA and proposes that the disease represents a diversity of clinical phenotypes that are underpinned by a number of molecular mechanisms, which may be shared by several phenotypes and targeted more specifically for therapeutic purposes. The clinical phenotypes of OA supposedly have different underlying etiologies and pathogenic pathways and they progress at different rates. Large OA population cohorts consist of a majority of patients whose disease progresses slowly and a minority of individuals whose disease may progress faster. The ability to identify the people with relatively rapidly progressing OA can transform clinical trials and enhance their efficiency. The identification, characterization, and classification of molecular phenotypes of rapidly progressing OA, which represent patients who may benefit most from intervention, could potentially serve as the basis for precision medicine for this disabling condition. Imaging and biochemical markers (biomarkers) are important diagnostic and research tools that can assist with this challenge.
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Affiliation(s)
- Ali Mobasheri
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, 08661, Lithuania.,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, FI-90014, Finland.,Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Queen's Medical Centre, Nottingham, UK.,ImmunoScience, Nordic Bioscience Biomarkers and Research, Herlev, DK-2730, Denmark
| | - Simo Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, FI-90014, Finland
| | - Mikko Finnilä
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, FI-90014, Finland
| | - Morten A Karsdal
- ImmunoScience, Nordic Bioscience Biomarkers and Research, Herlev, DK-2730, Denmark
| | | | - Willem Evert van Spil
- Division of Internal Medicine & Dermatology, Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.,Rheumatology, Dijklander Hospital, 1620 AR Hoorn, The Netherlands
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17
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Okano T, Mamoto K, Di Carlo M, Salaffi F. Clinical utility and potential of ultrasound in osteoarthritis. Radiol Med 2019; 124:1101-1111. [DOI: 10.1007/s11547-019-01013-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 02/21/2019] [Indexed: 02/06/2023]
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18
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Salaffi F, Carotti M, Barile A. Musculoskeletal imaging of the inflammatory and degenerative joints: current status and perspectives. LA RADIOLOGIA MEDICA 2019; 124:1067-1070. [PMID: 30810904 DOI: 10.1007/s11547-019-01004-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 02/11/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Fausto Salaffi
- Rheumatological Clinic, Ospedale "Carlo Urbani", Università Politecnica delle Marche, Jesi, Ancona, Italy.
| | - Marina Carotti
- Department of Radiology, Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
| | - Antonio Barile
- Department of Applied Clinical Science and Biotechnology, University of L'Aquila, L'Aquila, Italy
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19
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Sánchez Barrancos IM, Manso García S, Lozano Gago P, Hernández Rodríguez T, Conangla Ferrín L, Ruiz Serrano AL, González Santisteban R. [Usefulness and reliabitlity of musculoskeletal point of care ultrasound in family practice (2): Muscle injuries, osteoarthritis, rheumatological diseases and eco-guided procedures]. Aten Primaria 2019; 51:105-117. [PMID: 30591207 PMCID: PMC6837044 DOI: 10.1016/j.aprim.2018.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 07/02/2018] [Indexed: 11/30/2022] Open
Abstract
This article is a continuation of the review initiated in the previous issue about the usefulness of musculoskeletal point of care ultrasound in Primary Care, completing the scenarios of muscle injuries, osteoarthritis, rheumatological diseases and eco-guided procedures.
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Affiliation(s)
- Ignacio Manuel Sánchez Barrancos
- Miembro del Grupo de Trabajo de Ecografía de la Sociedad Española de Medicina Familiar y Comunitaria; Consultorio Local de Membrilla, Centro de Salud Manzanares 2, Gerencia de Atención Integrada de Manzanares, Ciudad Real, España.
| | | | - Pedro Lozano Gago
- Miembro del Grupo de Trabajo de Ecografía de la Sociedad Española de Medicina Familiar y Comunitaria; Departamento de Salud Alicante -San Joan, Centro de Salud Mutxamel, Alicante, España
| | - Trinidad Hernández Rodríguez
- Miembro del Grupo de Trabajo de Ecografía de la Sociedad Española de Medicina Familiar y Comunitaria; Sector Sanitario Alcañiz, Centro de Salud Andorral, Terue, España
| | - Laura Conangla Ferrín
- Miembro del Grupo de Trabajo de Ecografía de la Sociedad Española de Medicina Familiar y Comunitaria; EAP Badalona2. Centre Dalt La Villa. Badalona. Barcelona, España
| | - Antonio Lorenzo Ruiz Serrano
- Miembro del Grupo de Trabajo de Ecografía de la Sociedad Española de Medicina Familiar y Comunitaria; Centro de Salud Ciudad Real 3, Gerencia de Atención Integrada de Ciudad Real, Ciudad Real, España
| | - Roberto González Santisteban
- Miembro del Grupo de Trabajo de Ecografía de la Sociedad Española de Medicina Familiar y Comunitaria; Comarca Interior de Osakidetza, Consultorio de Ayala (Luyando-Respladiza), Álava, España
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20
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Ultrasonography of the late-stage knee osteoarthritis prior to total knee arthroplasty: comparison of the ultrasonographic, radiographic and intra-operative findings. Sci Rep 2018; 8:17742. [PMID: 30531827 PMCID: PMC6288097 DOI: 10.1038/s41598-018-35824-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 11/05/2018] [Indexed: 11/30/2022] Open
Abstract
The purpose of this study was to assess the effectiveness of the ultrasonography (US) on detecting osteoarthritis of the knee, and compare US and radiographic findings to intraoperative total knee arthroplasty (TKA) findings. Fifty-seven late-stage osteoarthritic knees undergoing TKA were evaluated with US and radiography. Standard knee US assessing femoral cartilage damage, osteophytes, effusion, synovitis, and meniscal extrusion was performed. On radiographs, osteophytes, joint space narrowing, and Kellgren-Lawrence grade were evaluated. Corresponding intra-operative findings were assessed during TKA as the gold standard. On the damage of the medial femoral condyle cartilage, the sensitivity of US was high (92%), whereas on the lateral condyle and sulcus area, sensitivities were 58% and 46%, respectively. On osteophytes, the detection rate of the US was remarkable especially on the medial side yielding sensitivities of 90–95%. The sensitivities for detecting effusion and synovitis were also excellent (97%). US detection rate of femoral cartilage damage was in concordance with the radiographic joint space narrowing. For the detection of osteophytes, US provided superior results to radiography particularly on the medial side. In conclusion, US can reliably assess the late-stage OA changes of the knee especially on the medial side of the knee joint.
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21
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Sconfienza LM, Albano D, Allen G, Bazzocchi A, Bignotti B, Chianca V, Facal de Castro F, Drakonaki EE, Gallardo E, Gielen J, Klauser AS, Martinoli C, Mauri G, McNally E, Messina C, Mirón Mombiela R, Orlandi D, Plagou A, Posadzy M, de la Puente R, Reijnierse M, Rossi F, Rutkauskas S, Snoj Z, Vucetic J, Wilson D, Tagliafico AS. Clinical indications for musculoskeletal ultrasound updated in 2017 by European Society of Musculoskeletal Radiology (ESSR) consensus. Eur Radiol 2018; 28:5338-5351. [DOI: 10.1007/s00330-018-5474-3] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/02/2018] [Accepted: 04/11/2018] [Indexed: 12/11/2022]
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22
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Maeguchi K, Ito H, Morita Y, Furu M, Fujii T, Azukizawa M, Okahata A, Nishitani K, Kuriyama S, Nakamura S, Matsuda S. How precisely does ultrasonographic evaluation reflect the histological status of the articular cartilage of the knee joint? J Orthop 2018; 15:636-640. [PMID: 29881210 DOI: 10.1016/j.jor.2018.05.046] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 05/07/2018] [Indexed: 01/27/2023] Open
Abstract
The thickness and the grade of the articular cartilages of the knee of 34 patients who underwent total knee arthroplasty were evaluated by ultrasound (US) and by histology. The US grade correlated with the histological grade and the thickness of the articular cartilage measured by US. The thickness measured by US was significantly correlated with that measured by histology for the medial condyle. The US thickness was significantly less than the histological thickness for thicker articular cartilages. US grading and the thickness of the articular cartilages evaluated by US is sufficiently reliable to indicate their histological status.
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Affiliation(s)
- Kosuke Maeguchi
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiromu Ito
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yugo Morita
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Moritoshi Furu
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takayuki Fujii
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masayuki Azukizawa
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akinori Okahata
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kohei Nishitani
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shinichi Kuriyama
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shinichiro Nakamura
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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