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

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.

scholarly journals Increase in medial meniscal extrusion in the weight-bearing position observed on ultrasonography correlates with lateral thrust in early-stage knee osteoarthritis

2020 ◽  
Vol 25 (4) ◽  
pp. 640-646 ◽  
Author(s):  
Yosuke Ishii ◽  
Masakazu Ishikawa ◽  
Hiroshi Kurumadani ◽  
Seiju Hayashi ◽  
Atsuo Nakamae ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Early Stage ◽  
Weight Bearing ◽  
Lateral Thrust ◽  
Meniscal Extrusion

Are OMERACT Knee Osteoarthritis Ultrasound Scores Associated With Pain Severity, Other Symptoms, and Radiographic and Magnetic Resonance Imaging Findings?

2020 ◽  
pp. jrheum.191291
Author(s):  
Win Min Oo ◽  
James M. Linklater ◽  
Kim L. Bennell ◽  
Danielle Pryke ◽  
Shirley Yu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Knee Osteoarthritis ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Power Doppler ◽  
Clinical Severity ◽  
Pain Severity ◽  
Resonance Imaging ◽  
Meniscal Extrusion

Objective To investigate the associations of Outcome Measures in Rheumatology (OMERACT) ultrasound scores for knee osteoarthritis (OA) with pain severity, other symptoms, and OA severity on radiographs and magnetic resonance imaging (MRI). Methods Participants with symptomatic and mild to moderate radiographic knee OA underwent baseline dynamic ultrasound (US) assessment according to standardized OMERACT scanning protocol. Using the published US image atlas, a physician operator obtained semiquantitative or binary scores for US pathologies. Clinical severity was measured on numerical rating scale (NRS) and Knee Injury and Osteoarthritis Outcome Score (KOOS) symptoms and pain subscores. OA severity was assessed using the Kellgren-Lawrence (KL) grade on radiographs and MRI Osteoarthritis Knee Score (MOAKS) on noncontrast-enhanced MRI. Separate linear regression models were used to determine associations of US OA pathologies with pain and KOOS subscores, and Spearman correlations were used for US scores with KL grade and MOAKS. Results Eighty-nine participants were included. Greater synovial hypertrophy, power Doppler (PD), and meniscal extrusion scores were associated with worse NRS pain [β 0.92 (95% CI 0.25–1.58), β 0.73 (95% CI 0.11–1.35), and β 1.01 (95% CI 0.22–1.80), respectively]. All greater US scores, except for cartilage grade, demonstrated significant associations with worse KOOS symptoms, whereas only PD and meniscal extrusion were associated with worse KOOS pain. All US scores, except for PD, were significantly correlated with KL grade. US pathologies, except for cartilage, revealed moderate to good correlation with their MOAKS counterparts, with US synovitis having the greatest correlation (0.69, 95% CI 0.60–0.78). Conclusion OMERACT US scores revealed significant associations with pain severity, KL grade, and MOAKS.

Pain perception in chronic knee osteoarthritis with varying levels of pain inhibitory control: an exploratory study

2020 ◽  
Vol 20 (4) ◽  
pp. 651-661
Author(s):  
Paulo E. P. Teixeira ◽  
Hanan I. Zehry ◽  
Swapnali Chaudhari ◽  
Laura Dipietro ◽  
Felipe Fregni
Keyword(s):  
Knee Osteoarthritis ◽  
Pain Intensity ◽  
Pain Perception ◽  
Small Sample Size ◽  
Linear Regression Analysis ◽  
Small Sample ◽  
Pain Modulation ◽  
Clinical Variables ◽  
Pain Scores ◽  
Intensity Perception

AbstractBackground and aimsPain is a disabling symptom in knee osteoarthritis (KOA) and its underlying mechanism remains poorly understood. Dysfunction of descending pain modulatory pathways and reduced pain inhibition enhance pain facilitation in many chronic pain syndromes but do not fully explain pain levels in chronic musculoskeletal conditions. The objective of this study is to explore the association of clinical variables with pain intensity perception in KOA individuals with varying levels of Conditioned Pain Modulation (CPM) response.MethodsThis is a cross-sectional, exploratory analysis using baseline data of a randomized clinical trial investigating the effects of a non-invasive brain stimulation treatment on the perception of pain and functional limitations due to KOA. Sixty-three subjects with KOA were included in this study. Data on pain perception, mood perception, self-reported depression, physical function, quality of life, and quantitative sensory testing was collected. Multiple linear regression analysis was performed to explore the association between the clinical variables with pain perception for individuals with different levels of CPM response.ResultsFor KOA patients with limited CPM response, perception of limitations at work/other activities due to emotional problems and stress scores were statistically significantly associated with pain scores, F(2, 37) = 7.02, p < 0.01. R-squared = 0.275. For KOA patients with normal CPM response, general health perception scores were statistically significantly associated with pain scores, F(1, 21) = 5.60, p < 0.05. R-squared = 0.2104. Limitations of this study include methodology details, small sample size and study design characteristics.ConclusionsPain intensity perception is associated differently with clinical variables according to the individual CPM response. Mechanistic models to explain pain perception in these two subgroups of KOA subjects are discussed.

The role of rehabilitation exercises on weight, functional strength and exercise adherence in knee osteoarthritis patients

2021 ◽  
Vol 17 ◽  
Author(s):  
Muhammad Tariq Rafiq ◽  
Mohamad Shariff Abdul Hamid ◽  
Eliza Hafiz ◽  
Khalid Rashid ◽  
Farid Ahmad Chaudhary
Keyword(s):  
Knee Osteoarthritis ◽  
Weight Bearing ◽  
Exercise Adherence ◽  
Lower Limbs ◽  
Joint Disease ◽  
Control Group ◽  
Post Test ◽  
Rehabilitation Exercises ◽  
Normally Distributed

Introduction: Knee osteoarthritis (OA) is a weight-bearing joint disease and is more common in overweight and obese persons. The objective of this study was to determine the role of rehabilitation exercises (REs) of lower limbs on weight, functional strength, and exercise adherence in overweight and obese knee OA patients. Materials And Method: The patients were recruited from the Urban community of Lahore, Pakistan. The patients were divided into the rehabilitation group (RG) and control group (CG). The patients in the RG performed the REs of lower limbs and followed the instructions of daily care (IDC), while the patients in the CG only followed the IDC for 12 weeks. Outcome measures were assessed at pre-test before grouping and post-test after 12-weeks of interventions. The measures included: weight, functional strength, and exercise adherence. The Paired Samples t-test (for the normally distributed data) and the Wilcoxon Signed Ranked Test (for the data that was not normally distributed) were used to analyze the differences within groups from pre to post-test measurements. The analysis of variance 2 × 2 factors and the Mann-Whitney U-test were used to analyze the difference of weight and functional strength respectively between the groups. Results: The patients in the RG reported a statistically significant weight reduction (p < 0.001) and improvement in the functional strength (p < 0.001) within the group. Similarly, the patients in the CG also reported a significant improvement in the scores of functional strength (p = 0.004) within the group. The improvement in the scores of functional strength was greater in the patients of RG than the CG (p < 0.001. Similarly, the patients in the RG reported a statistically significant reduction in weight than the CG (p < 0.001). Conclusion: The REs could improve weight, functional strength and exercise adherence.

scholarly journals Epidemiological study on the relationship among menopausal condition, bone fragility, and knee osteoarthritis

2020 ◽  
Author(s):  
Eiji Sasaki ◽  
Daisuke Chiba ◽  
Seiya Ota ◽  
Yuka Kimura ◽  
Shizuka Sasaki ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Knee Osteoarthritis ◽  
Epidemiological Study ◽  
Odds Ratio ◽  
Weight Bearing ◽  
Predictive Marker ◽  
P Value ◽  
Mineral Density ◽  
High Turnover ◽  
The Relationship

Abstract Background: Knee osteoarthritis (KOA) occurs more often in middle-aged females. While this age-group experiences comorbid osteoporosis with menopause, its influence on KOA has not been clarified. This epidemiological study aimed to investigate the relationship between menopausal conditions, bone mineral density (BMD), and KOA. Methods: A total of 518 female volunteers who participated in the Iwaki cohort study were enrolled and divided into groups (pre- and post-menopause). Antimullerian hormone (AMH) was measured as a predictive marker for menopause in the pre-menopausal subjects. Weight-bearing anterior-posterior knee radiographs were classified by Kellgren-Lawrence grade, and grade ≥ 2 was defined as definitive KOA (DKOA). Early KOA (EKOA) was defined by Luyten’s criteria, and BMD was measured at a distal radius. The relationship between menopausal condition, BMD, and KOA was analyzed by ROC and regression analysis. Results: Fifty-two participants (10.0%) were diagnosed with EKOA and 204 (39.4%) with DKOA. A total of 393 (75.9%) females began menopause, and the prevalence of DKOA was up to 48.1% and >12.0% in pre-menopause females (p < 0.001, Odds ratio: 6.79). From the ROC analysis in pre-menopausal females, cut-off value of AMH for detecting EKOA was 0.08 ng/ml (AUC: 0.712, p5%CI: 0.527 to 0.897, p-value: 0.025, Odds ratio: 8.28). Regression analysis showed that lower AMH was related to EKOA (p=0.035, Odds ratio: 5.55) and DKOA (p=0.032, Odds 1.59), and lower BMD and high turnover bone metabolism were correlated with DKOA. Conclusions: KOA increased after menopause and was correlated with lower BMD. Furthermore, reduction in AMH was a valuable biomarker for the detection of EKOA.

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