Chan Keith K W, Sit Regina W S, Wu Ricky W K, Ngai Allen H Y
School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
PLoS One. 2014 Mar 27;9(3):e92901. doi: 10.1371/journal.pone.0092901. eCollection 2014.
Pain is the predominant symptom of knee osteoarthritis (OA) and the main reason of disability. Ultrasound is now one of the new imaging modality in Musculoskeletal medicine and its role in assessing the pain severity in the knee osteoarthritis is evaluated in this study.
(1) To study the correlation between ultrasonographic (US) findings and pain score and (2) whether ultrasonographic findings show a better association of pain level than conventional X-rays in patients suffering from primary knee osteoarthritis.
In this multi-center study, 193 patients with primary knee OA were asked to score their average knee pain using the Western Ontario and McMaster Universities Arthritis (WOMAC) questionnaire;patients would then go for a radiological and an US evaluation of their painful knee. Findings from both imaging modalities will be studied with the associated pain score.
Ultrasound showed that knee effusion has positive correlation with pain score upon walking (r = 0.217) and stair climbing (r = 0.194). Presence of suprapatellar synovitis had higher pain score on sitting (Spearman's Rank correlation = 0.355). The medial(r = 0.170) and lateral meniscus protrusion (r = 0.201) were associated with pain score upon stair climbing.
Our study found that both imaging modalities shown some significant association with the aspect of pain; neither one is clearly better but rather complementary to each other. A trend is found in both modalities: walking pain is related to pathologies of the either the lateral or medial tibiofemoral joint(TFJ)while stair climbing pain is related to both tibiofemoral joint pathologies and also to the patellofemoral joint (PFJ) pathology. This suggested that biomechanical derangement is an important aspect in OA knee pain.
疼痛是膝关节骨关节炎（OA）的主要症状，也是致残的主要原因。超声是目前肌肉骨骼医学中的一种新型成像方式，本研究评估了其在评估膝关节骨关节炎疼痛严重程度方面的作用。
（1）研究超声（US）检查结果与疼痛评分之间的相关性；（2）在原发性膝关节骨关节炎患者中，超声检查结果与疼痛程度的关联是否比传统X线检查更好。
在这项多中心研究中，193例原发性膝关节OA患者被要求使用西安大略和麦克马斯特大学骨关节炎（WOMAC）问卷对其平均膝关节疼痛进行评分；然后患者将对其疼痛的膝关节进行放射学和超声评估。将对两种成像方式的检查结果与相关疼痛评分进行研究。
超声显示，膝关节积液与行走时疼痛评分呈正相关（r = 0.217），与爬楼梯时疼痛评分呈正相关（r = 0.194）。髌上滑膜炎的存在使患者坐位时疼痛评分更高（Spearman等级相关性= 0.355）。内侧半月板（r = 0.170）和外侧半月板突出（r = 0.201）与爬楼梯时疼痛评分相关。
我们的研究发现，两种成像方式均与疼痛方面存在一些显著关联；两者都没有明显更好，而是相互补充。在两种成像方式中都发现了一种趋势：行走疼痛与胫股关节（TFJ）外侧或内侧的病变有关，而爬楼梯疼痛与胫股关节病变以及髌股关节（PFJ）病变均有关。这表明生物力学紊乱是OA膝关节疼痛的一个重要方面。
