The Updated Role of Ultrasound in the Assessment of Knee Osteoarthritis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khalid Esmat Alaam ◽  
Hazem Ibrahim Abd El Rahman ◽  
Nouran Saieed Ahmed
Keyword(s):  
Knee Osteoarthritis ◽  
Clinical Examination ◽  
Structural Damage ◽  
Cartilage Degeneration ◽  
University Hospitals ◽  
Meniscal Extrusion ◽  
Clinical Criteria ◽  
Knee Effusion ◽  
Monitoring Therapy ◽  
Meniscal Degeneration

Abstract Background Osteoarthritis (OA) of the knee is the most common form of knee arthritis and a leading cause of chronic disability. Objective The aim of the current study is to reassess the utility of the updated ultrasound in the patients with knee osteoarthritis and outline its clinical application. Patients and Methods The studied group included 36 patient 23females and 13 males with their ages ranged between 39 and 58 years (average age 44 years). The patients were referred to US examination fulfilling the ACR clinical criteria for knee OA after orthopedic and /or rheumatologist consultation. The study was performed in Radiodiagnosis department Ain Shams University Hospitals (20 patients ) and at one private center (16 patients). Results There was a discrepancy between the results obtained by clinical examination and those demonstrated by ultrasonography. Clinical examination detected 22 (61.1%) of our cases. Prevalence of US findings in our cases were femoral articular degeneration in 28 (77.7%) patients, Tibiofemoral osteophytes were seen in 26 patients (72.2%), knee effusion in 22 patients (61.1%),meniscal extrusion in 22 patients (61.1%) meniscal degeneration in 17 patients (47.2%) and synovial hypertrophy in 15patients (41.6%). Baker’s cysts were demonstrated in 14patients (38.8%) while pes anserine syndrome was demonstrated in 4 cases. Meniscal degeneration and meniscal extrusion were correlated significantly with femoral cartilage degeneration (P<.001). Although knee effusion did not correlate with advanced knee effusion did significantly (P > 0.05). Baker's cysts is statistically related to the presence and severity of mensical changes and also related to the degree of femoral articular cartilage degeneration. Conclusion US is a valuable technique that can assess soft tissue structures within the knee and their involvement in the osteoarthritic process .US enables in guiding and monitoring therapy through detection of knee structural damage.

Dose-Dependent Effects of Interleukin-1Alpha on Functional Degradation of Lateral and Medial Menisci

2010 ◽  
Author(s):  
Carrie H. Ling ◽  
Janice H. Lai ◽  
James F. Nishimuta ◽  
Marc E. Levenston
Keyword(s):  
Interleukin 1 ◽  
Cartilage Degeneration ◽  
Meniscal Extrusion ◽  
Knee Oa ◽  
Degenerative Lesion ◽  
Disease Modifying Treatment ◽  
Dose Dependent ◽  
Meniscal Degeneration ◽  
Pro Inflammatory Cytokines

Despite a growing recognition that meniscal degeneration often precedes cartilage degeneration in the development of knee osteoarthritis (OA), little is known about the role of meniscal degeneration in the onset and progression of knee OA. Even a mild degenerative lesion increases meniscal extrusion, implying changes in biomechanical function. Understanding the mechanisms of meniscal degeneration may enable the diagnosis and disease-modifying treatment of early knee OA, potentially preventing or slowing the progression of the disease. The roles of pro-inflammatory cytokines such as interleukin-1 (IL-1) in promoting cartilage matrix degradation and mediating inflammation in the progression of OA have been widely demonstrated [1,2]. Recent results from our group indicated that 20ng/ml hrIL-1α produced similar cell-mediated degradation and loss of mechanical properties in immature cartilage and meniscus, but progresses more rapidly in meniscus explants [3]. This study further explored the effects of IL-1α dosage and medial-lateral differences on the functional degradation of meniscal explants.

scholarly journals AB0863 RADIOGRAPHY VERSUS ULTRASONOGRAPHY – WHICH IMAGING MODALITY TELLS US MORE ABOUT PAIN SEVERITY IN KNEE OSTEOARTHRITIS?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1738.2-1739
Author(s):  
G. Gerganov ◽  
T. Georgiev ◽  
T. Shivacheva
Keyword(s):  
Knee Osteoarthritis ◽  
Structural Damage ◽  
Pain Perception ◽  
Weight Bearing ◽  
Pain Severity ◽  
Imaging Modalities ◽  
Popliteal Cyst ◽  
Meniscal Extrusion ◽  
Femoral Cartilage ◽  
Cardinal Symptom

Background:Osteoarthritis (OA) is a leading cause of disability worldwide and pain is its cardinal symptom. Ranging from structural injuries to central sensitization, multifactorial mechanisms play an important role in pain perception in patients with knee OA (KOA) defining a discrepancy between pain and structural damage. Imaging modalities such as radiography and musculoskeletal ultrasonography may assess those structural findings and both are well embedded in routine clinical practice. However, their association with pain severity is poorly studied.Objectives:To evaluate the place of X-ray- and ultrasound-derived parameters of structural damage for pain perception in knee osteoarthritis patients.Methods:Sixty-four knees from 38 patients with KOA fulfilling the ACR criteria were assessed. The pain severity was evaluated in all knees by 100-millimeters (mm) visual analogue scale (VAS). Anteroposterior radiographs of the fully extended knees in an upright weight-bearing position were obtained and images were evaluated according to the Kellgren-Lawrence (KL) and OARSI atlas. All patients were investigated with a portable MyLab 25 Gold system equipped with an LA435 transducer (Esaote SpA, Genoa, Italy) by two experienced ultrasonographers. The presence or absence of synovial thickening, effusion in the suprapatellar bursa, and popliteal cyst were assessed. Medial meniscal extrusion and medial and lateral femoral cartilage thickness (medial and lateral) were measured in mm in full extension and flexion position, respectively. Femoral osteophytes were semi-quantitatively scored using a scale consisted of four grades (0-3).Results:The levels of pain differed significantly in the KL groups (p = .001) and in the groups classified according to the medial tibiofemoral compartment narrowing defined in line with the OARSI atlas (p = .005). The other knee osteoarthritis radiographic characteristics derived from the OARSI atlas did not correlate with the pain. From the assessed ultrasound parameters, medial meniscal extrusion and medial femoral cartilage showed a weak correlation with pain levels (r = .254, p = .043; r = -.265, p = 0.034, respectively). Nevertheless, in the multivariate analysis after adjusting for age and BMI, both variables did not reach significance for explaining the differences in VAS levels. No association between the presence of synovial effusion and popliteal cyst and pain severity was found.Conclusion:Plain radiography and ultrasonography reflect different structural changes in osteoarthritis that may play an important role in pain perception. Both imaging modalities can complement each other in order to improve the evaluation of the patient with KOA.Acknowledgments:NoneDisclosure of Interests:None declared

scholarly journals Knee effusion evaluated by ultrasonography warns knee osteoarthritis patients to develop their muscle atrophy: a three-year cohort study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Daisuke Chiba ◽  
Seiya Ota ◽  
Eiji Sasaki ◽  
Eiichi Tsuda ◽  
Shigeyuki Nakaji ◽  
...  
Keyword(s):  
Cohort Study ◽  
Knee Osteoarthritis ◽  
Muscle Atrophy ◽  
Knee Effusion

scholarly journals Experience of living with knee osteoarthritis: a systematic review of qualitative studies

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030060 ◽  
Author(s):  
Jason A Wallis ◽  
Nicholas F Taylor ◽  
Samantha Bunzli ◽  
Nora Shields
Keyword(s):  
Systematic Review ◽  
Knee Osteoarthritis ◽  
Lived Experience ◽  
Structural Damage ◽  
Social Impact ◽  
Qualitative Studies ◽  
Emotional Impact ◽  
Management Options ◽  
Key Factor ◽  
Reporting Data

ObjectivesSystematically review the qualitative literature on living with knee osteoarthritis from patient and carer perspectives.DesignSystematic review of qualitative studies. Five electronic databases (CINAHL, Embase, MEDLINE, PsycINFO, SPORTDiscus) were searched from inception until October 2018. Data were synthesised using thematic and content analysis.ParticipantsStudies exploring the experiences of people living with knee osteoarthritis, and their carers were included. Studies exploring experiences of patients having participated in specific interventions, including surgery, or their attitudes about the decision to proceed to knee replacement were excluded.ResultsTwenty-six articles reporting data from 21 studies about the patient (n=665) and carer (n=28) experience of living with knee osteoarthritis were included. Seven themes emerged: (i) Perceived causes of knee osteoarthritis are multifactorial and lead to structural damage to the knee and deterioration over time (n=13 studies), (ii) Pain and how to manage it predominates the lived experience (n=19 studies), (iii) Knee osteoarthritis impacts activity and participation (n=16 studies), (iv) Knee osteoarthritis has a social impact (n=10 studies), (v) Knee osteoarthritis has an emotional impact (n=13 studies), (vi) Interactions with health professionals can be positive or negative (n=11 studies), (vii) Knee osteoarthritis leads to life adjustments (n=14 studies). A single study reporting the perspectives of carers reported similar themes. Psychosocial impact of knee osteoarthritis emerged as a key factor in the lived experience of people with knee osteoarthritis.ConclusionsThis review highlights the value of considering patient attitudes and experiences including psychosocial factors when planning and implementing management options for people with knee osteoarthritis.Trial registrationnumberCRD42018108962

The Detection of Arthrokinetic Biomarkers for Osteoarthritis in Partial Medial Meniscectomy Patients

2012 ◽  
Author(s):  
Chelsea Marsh ◽  
Jing Tang ◽  
Scott Tashman
Keyword(s):  
High Risk ◽  
Knee Osteoarthritis ◽  
Structural Damage ◽  
Cartilage Damage ◽  
Surface Damage ◽  
Cartilage Loss ◽  
Meniscal Injury ◽  
Meniscal Tears ◽  
Medial Meniscectomy ◽  
Injured Knee

Meniscal injury has been found to leave patients at high risk for the development of knee osteoarthritis (OA). Partial meniscectomy is often used to treat meniscal tears, and while this procedure adequately addresses pain and the restoration of function, it does not prevent the progression of OA in the injured knee. Often during arthroscopy, surgeons identify areas of “softened” cartilage, which do not always correlate with visible signs of surface damage or cartilage loss. This softening has been related to changes in the cartilage matrix, which could represent early structural damage that can lead to irreversible cartilage damage and OA.

scholarly journals Factors associated with longitudinal change of meniscal extrusion in overweight women without clinical signs of knee osteoarthritis

2019 ◽  
Vol 27 ◽  
pp. S337-S338
Author(s):  
J.A. van der Voet ◽  
D. Wesselius ◽  
D. Vroegindeweij ◽  
E.H. Oei ◽  
S.M. Bierma - Zeinstra ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Clinical Signs ◽  
Longitudinal Change ◽  
Meniscal Extrusion ◽  
Overweight Women ◽  
Factors Associated

scholarly journals Do body mass index and knee osteoarthritis status affect meniscal extrusion and size?

2019 ◽  
Vol 27 ◽  
pp. S368 ◽  
Author(s):  
I.P. Munugoda ◽  
D.A. Aitken ◽  
W. Wirth ◽  
F. Eckstein
Keyword(s):  
Body Mass Index ◽  
Knee Osteoarthritis ◽  
Body Mass ◽  
Meniscal Extrusion
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