Jung Y O, Do J-H, Kang H-J, Yoo S-A, Yoon C-H, Kim H-A, Cho C-S, Kim W-U
Department of Internal Medicine, Division of Rheumatology, Hallym University Medical College, Chuncheon, South Korea.
Clin Exp Rheumatol. 2006 May-Jun;24(3):253-9.
Ultrasonography can be used to detect soft tissue abnormalities within the joints that cannot be assessed using conventional X-rays. This study investigated the relationship between soft tissue and/or bony abnormalities on ultrasonography and the biochemical markers of the synovium and cartilage in the knee of osteoarthritis (OA) patients.
The knees from 51 OA patients who fulfilled the ACR criteria were enrolled in this study. Knee ultrasonography was performed in the affected knee joints using a 12 MHz linear probe to assess the presence of effusion, synovial proliferation, capsular distention, the length of osteophytes and the cartilage thickness. At the same time, the serum hyaluronic acid (HA) and the cartilage oligomeric protein (COMP) levels were measured by ELISA, and RIA was used to determine the serum osteocalcin levels.
The patients with a longer medial osteophyte showed higher serum HA and COMP levels than those with a shorter one. The serum HA levels were significantly higher in those patients with a larger amount of effusion and/or synovial proliferation, which indicated inflammatory changes, than in those without. In addition, the severity of the capsular distention also correlated well with the serum HA and COMP levels. However, the length of the lateral osteophytes and the thickness of the femoral cartilage showed no correlation with the serum HA or COMP levels. In addition, the serum osteocalcin levels did not show any association with the above ultrasonographic parameters.
This study demonstrated that the serum HA and COMP levels were elevated in the more severe OA patients by knee ultrasonography than in the less severe patients. This suggests that the detailed pathological changes in the soft tissue and/or bone of the OA joints on ultrasonography are directly reflected by the biochemical markers measured in the peripheral blood.
超声检查可用于检测关节内常规X线无法评估的软组织异常。本研究调查了骨关节炎（OA）患者膝关节超声检查中软组织和/或骨异常与滑膜及软骨生化标志物之间的关系。
本研究纳入了51例符合美国风湿病学会（ACR）标准的OA患者的膝关节。使用12MHz线性探头对患侧膝关节进行超声检查，以评估积液、滑膜增生、关节囊扩张、骨赘长度和软骨厚度。同时，采用酶联免疫吸附测定法（ELISA）检测血清透明质酸（HA）和软骨寡聚蛋白（COMP）水平，放射免疫分析法（RIA）测定血清骨钙素水平。
内侧骨赘较长的患者血清HA和COMP水平高于骨赘较短的患者。积液和/或滑膜增生较多（提示有炎症改变）的患者血清HA水平显著高于无上述情况的患者。此外，关节囊扩张的严重程度也与血清HA和COMP水平密切相关。然而，外侧骨赘长度和股骨软骨厚度与血清HA或COMP水平无相关性。此外，血清骨钙素水平与上述超声参数均无关联。
本研究表明，通过膝关节超声检查发现，较严重OA患者的血清HA和COMP水平高于病情较轻的患者。这表明OA关节软组织和/或骨的详细病理变化可在外周血中检测的生化标志物上直接体现出来。
