Background/Purpose:

To evaluate and to compare ultrasonographic (US) features to clinical data and structural damage in symptomatic radiographic (RX) knee osteoarthritis (OA).

Methods:

Patients with symptomatic (VAS-pain > 30/100) and RX (Kellgren-Lawrence (KL)≥2) knee OA responding to ACR criteria (1986) were included in a clinical trial N° NCT01544647. Clinical knee effusion, VAS-pain, WOMAC scores and radiographic severity (KL>2) were recorded. On US, effusion (≥ 4 mm), synovitis (depicted in the three subquadricipital ramps on B- and PD-modes) and Baker’s cyst (BC) were assessed according to binary and semi quantitative manners. Total US score (sum of effusion (0 to 6), synovitis scores (0- 15) and presence of BC (0-1)) varied from 0 to 22.

Results: 283 patients were evaluated (67% of women, mean age (SD): 64.1(±9.1) years, BMI: 29.1(±5.7), 58.4% with KL>2). Knee effusion was detected in 82 patients (29.1%) by clinical examination and in 185 patients (65.6%) by US. On US, synovitis was detected in 60.3% on B-mode and 28.0% on PD-mode. BC was observed in 70 patients (24.9%). The mean +/-SD effusion, synovitis and total US scores were 0.8±1.2, 2.5±2.6 and 3.6±3.4 respectively. For an US effusion score >2, more than 50% of knee effusions were clinically detected. Only effusion score was associated with VAS-pain (p=0.01) on univariate analysis. There was a significant association between RX severity and US effusion and synovitis scores (B-mode and DP-mode) in univariate and multivariate analysis (p<0.05).

Conclusion:

US detected two times more knee effusion than clinical examination and only US effusion score demonstrated association with pain. US effusion and synovitis were strongly associated to structural damages.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/contribution-of-ultrasonography-examination-in-symptomatic-radiographic-knee-oa/