Comparison of Diagnostic Performance of Semi-Quantitative Knee Ultrasound and Knee Radiography with MRI: Oulu Knee Osteoarthritis Study
Comparison of Diagnostic Performance of Semi-Quantitative Knee Ultrasound and Knee Radiography with MRI: Oulu Knee Osteoarthritis Study
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DOI：
10.1038/srep22365
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发表时间：
2016-03-01
影响因子：
4.6
通讯作者：
Saarakkala, Simo
中科院分区：
文献类型：
--
作者：
Podlipska, Jana;Guermazi, Ali;Saarakkala, Simo
骨关节炎（OA）是一种常见的退行性肌肉骨骼疾病，在全球老龄化社会中非常普遍。传统上，膝关节骨性关节炎是使用传统的X线摄影诊断。然而，不能使用该方法直接评估关节软骨或关节软骨的结构变化。另一方面，超声是一种很有前途的工具，能够提供软组织变性的直接信息。本研究的目的是系统地确定特定部位的诊断性能的半定量超声分级的膝关节股骨关节软骨，骨赘和股骨突出，和放射学评估关节间隙狭窄和骨赘，使用MRI作为参考标准。80例无症状受试者和79例有症状受试者（平均年龄57.7岁）被纳入研究。超声在评估股骨内侧和外侧骨赘以及内侧股骨突出方面表现最好。与X线片相比，超声在识别胫股骨赘、内侧股骨突出和内侧股骨软骨形态退变方面表现更好或至少同样好。超声提供了常规X线摄影无法描述的组织特异性形态学变化的相关额外诊断信息。因此，使用超声作为补充成像工具沿着X线摄影，可以在初级医疗水平上实现膝关节骨关节炎的更准确和更具成本效益的诊断。
Osteoarthritis (OA) is a common degenerative musculoskeletal disease highly prevalent in aging societies worldwide. Traditionally, knee OA is diagnosed using conventional radiography. However, structural changes of articular cartilage or menisci cannot be directly evaluated using this method. On the other hand, ultrasound is a promising tool able to provide direct information on soft tissue degeneration. The aim of our study was to systematically determine the site-specific diagnostic performance of semi-quantitative ultrasound grading of knee femoral articular cartilage, osteophytes and meniscal extrusion, and of radiographic assessment of joint space narrowing and osteophytes, using MRI as a reference standard. Eighty asymptomatic and 79 symptomatic subjects with mean age of 57.7 years were included in the study. Ultrasound performed best in the assessment of femoral medial and lateral osteophytes, and medial meniscal extrusion. In comparison to radiography, ultrasound performed better or at least equally well in identification of tibio-femoral osteophytes, medial meniscal extrusion and medial femoral cartilage morphological degeneration. Ultrasound provides relevant additional diagnostic information on tissue-specific morphological changes not depicted by conventional radiography. Consequently, the use of ultrasound as a complementary imaging tool along with radiography may enable more accurate and cost-effective diagnostics of knee osteoarthritis at the primary healthcare level.