Cattedra di Reumatologia, Sapienza Università di Roma, Italy.
Clin Exp Rheumatol. 2010 Sep-Oct;28(5):643-6. Epub 2010 Oct 28.
To investigate the prevalence and severity of sonographic-detected abnormalities in knee osteoarthritis (OA) and to correlate ultrasound (US) findings with clinical data.
Outpatients with chronic, painful knee OA according to the ACR criteria were consecutively recruited and underwent clinical and US examinations. An expert rheumatologist recorded the presence of knee joint pain, swelling and tenderness, patient's global assessment of knee pain using visual analogue scale (VAS), and Lequesne Index of severity for knee OA. A second rheumatologist, blinded to the clinical data, performed the knee US examination using a Logiq9 machine equipped with a 12MHz linear probe and registering the presence of joint effusion, synovial proliferation, power Doppler (PD) signal, Baker's cyst, osteophytes and femoral cartilage abnormalities.
One hundred and sixty-four knees of 82 patients (53 women, 29 men) were studied; mean age was 63.2±8.1 SD years, mean disease duration was 4.3±5.6 SD years. All patients complained of at least one knee joint pain during physical activity. Mean patient's VAS for knee pain was 48.4±19.9 SD mm, mean Lequesne Index was 8.2±4.4 SD. Knee swelling was present in 39% of the patients and tenderness was found in 65.8%. US showed: joint effusion in 43.3% of the patients, synovial proliferation in 22.1%, PD signal in 2.9%, Baker's cysts in 6.6%, cartilage abnormalities in 79%, osteophytes in 100%. In all patients US findings were present at least at the level of one knee. Statistically significant correlations were demonstrated between a composite inflammatory score and both VAS (p=0.004) and Lequesne Index (p<0.0001).
This US study showed both inflammatory abnormalities and structural damage lesions in knee OA. Interestingly, statistically significant correlations were demonstrated between US inflammatory findings and the main clinical tests for OA, confirming that sonography has a relevant role in the global evaluation of patients with knee OA.
研究膝关节骨关节炎（OA）超声检测异常的流行率和严重程度，并将超声检查结果与临床数据相关联。
根据 ACR 标准连续招募患有慢性、疼痛性膝关节 OA 的门诊患者，并进行临床和超声检查。一名专家风湿病学家记录膝关节疼痛、肿胀和压痛的存在，患者使用视觉模拟量表（VAS）对膝关节疼痛的总体评估，以及 Lequesne 膝关节 OA 严重程度指数。第二位风湿病学家，对临床数据不知情，使用配备 12MHz 线性探头的 Logiq9 机器进行膝关节超声检查，并记录关节积液、滑膜增生、功率多普勒（PD）信号、贝克氏囊肿、骨赘和股骨软骨异常的存在。
共研究了 82 名患者的 164 个膝关节（53 名女性，29 名男性）；平均年龄为 63.2±8.1 岁，平均病程为 4.3±5.6 岁。所有患者在进行体育活动时至少有一个膝关节疼痛。平均患者膝关节 VAS 疼痛为 48.4±19.9 毫米，平均 Lequesne 指数为 8.2±4.4 分。39%的患者存在膝关节肿胀，65.8%的患者存在压痛。超声检查显示：43.3%的患者存在关节积液，22.1%的患者存在滑膜增生，2.9%的患者存在 PD 信号，6.6%的患者存在贝克氏囊肿，79%的患者存在软骨异常，100%的患者存在骨赘。在所有患者中，超声检查结果至少在一个膝关节上存在。炎症综合评分与 VAS（p=0.004）和 Lequesne 指数（p<0.0001）均呈显著相关。
本研究表明膝关节 OA 既存在炎症异常，也存在结构损伤病变。有趣的是，超声检查炎症发现与 OA 的主要临床检查呈显著相关，这证实了超声在膝关节 OA 患者的整体评估中具有重要作用。
