Okano Tadashi, Filippucci Emilio, Di Carlo Marco, Draghessi Antonella, Carotti Marina, Salaffi Fausto, Wright Gary, Grassi Walter
Department of Rheumatology, Università Politecnica delle Marche, Ospedale "C. Urbani", Ancona, Italy.
Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Rheumatology (Oxford). 2016 Nov;55(11):2040-2049. doi: 10.1093/rheumatology/kew304. Epub 2016 Aug 24.
The main aim of this study was to compare ultrasonography (US) with conventional radiography for the assessment of joint damage in knee OA.
A total of 166 knees of 84 patients (59 women and 25 men) with primary knee OA were included in this study. The femoral hyaline cartilage of the medial para-patellar aspect and the osteophytes of both the medial and lateral femoral condyle were assessed. The cartilage and osteophytes were both quantitatively and qualitatively assessed. The US assessment was feature-specifically compared with conventional radiography.
There was a strong correlation between the radiographic medial tibiofemoral narrowing grade and the US medial cartilage grade (r = 0.7144, 95% CI: 0.6218, 0.7873, P < 0.0001). In the detailed analysis, US could assess cartilage damage more correctly by using the direct visualization technique. A strong correlation was also found between the radiographic and the US medial femoral osteophyte grade (r = 0.7515, 95% CI: 0.6659, 0.8176, P < 0.0001) and between the radiographic and the US lateral femoral osteophyte grade (r = 0.6947, 95% CI: 0.5941, 0.7739, P < 0.0001). US detected osteophytes in 46 sites at which conventional radiography did not detect any osteophytes.
The present feature-specific comparison study provides evidence supporting the concurrent validity of US in the assessment of knee joint damage due to OA through its agreement with conventional radiography. Moreover, US was found to be a sensitive imaging technique for revealing cartilage damage and even minimal osteophytes, especially in the early radiographic stages of knee OA.
本研究的主要目的是比较超声检查（US）与传统X线摄影在评估膝关节骨关节炎（OA）关节损伤方面的差异。
本研究纳入了84例原发性膝关节OA患者（59例女性和25例男性）的166个膝关节。评估了髌内侧股骨透明软骨以及股骨内外侧髁的骨赘。对软骨和骨赘进行了定量和定性评估。将超声检查结果与传统X线摄影进行了特征特异性比较。
X线片显示的胫股内侧狭窄程度与超声检查的内侧软骨分级之间存在强相关性（r = 0.7144，95%CI：0.6218，0.7873，P < 0.0001）。在详细分析中，超声检查通过直接可视化技术能更准确地评估软骨损伤。X线片与超声检查的股骨内侧骨赘分级之间也存在强相关性（r = 0.7515，95%CI：0.6659，0.8176，P < 0.0001），X线片与超声检查的股骨外侧骨赘分级之间同样存在强相关性（r = 0.6947，95%CI：0.5941，0.7739，P < 0.0001）。超声检查在46个传统X线摄影未检测到骨赘的部位检测到了骨赘。
本特征特异性比较研究提供了证据，支持超声检查在评估OA所致膝关节损伤方面与传统X线摄影具有一致性，从而证明其同时效度。此外，超声检查被发现是一种敏感的成像技术，可用于揭示软骨损伤甚至微小骨赘，尤其是在膝关节OA的早期X线阶段。
