Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, UK; Arthritis Research UK Pain Centre, and NIHR Nottingham BRC, Nottingham, UK.
Arthritis Research UK Pain Centre, and NIHR Nottingham BRC, Nottingham, UK; School of Health Sciences, University of Nottingham, UK.
Osteoarthritis Cartilage. 2019 Mar;27(3):435-443. doi: 10.1016/j.joca.2018.09.018. Epub 2018 Nov 16.
To establish "normal" ranges for synovial thickness and effusion detected by ultrasound (US) and to determine cut-offs associated with knee pain (KP) and radiographic knee osteoarthritis (RKOA) in the community.
147 women and 152 men ≥40 years old were randomly selected from the Nottingham KP and Related Health in the Community (KPIC) cohort (n = 9506). The "normal" range was established using the percentile method in 163 participants who had no KP and no RKOA. Optimal (maximum sensitivity and specificity) and high specificity (90%) cut-offs were established using receiver operating characteristic (ROC) curve analysis in a comparison between people with both KP and RKOA and normal controls.
Effusion and synovial hypertrophy differed by gender but not by age or laterality, therefore gender-specific reference limits were estimated. However, the "normal" ranges between men and women were similar for effusion (0-10.3 mm vs 0-9.8 mm), but different for synovial hypertrophy (0-6.8 mm vs 0-5.4 mm). Power Doppler Signal (PDS) in the healthy controls was uncommon (1.2% in men and 0.0% in women). The optimal cut-off was 7.4 mm for men and 5.3 mm for women for effusion, and 3.7 and 1.6 for hypertrophy respectively. The high specificity cut-off was 8.9 for men and 7.8 for women for effusion, and 5.8 and 4.2 for hypertrophy respectively.
US effusion and synovial hypertrophy but not PDS are common, but differ by gender, in community-derived people without painful knee OA. Currently used cut-offs for abnormality need reappraisal.
建立超声（US）检测到的滑膜厚度和积液的“正常”范围，并确定与社区膝关节疼痛（KP）和放射学膝关节骨关节炎（RKOA）相关的切点。
从诺丁汉 KP 和相关社区健康（KPIC）队列中随机选择 147 名女性和 152 名年龄≥40 岁的男性（n=9506）。在没有 KP 和 RKOA 的 163 名参与者中，使用百分位数法建立“正常”范围。在 KP 和 RKOA 并存的人与正常对照组之间的比较中，使用受试者工作特征（ROC）曲线分析建立最佳（最大敏感性和特异性）和高特异性（90%）切点。
积液和滑膜增生因性别而异，但与年龄或侧别无关，因此估计了性别特异性参考范围。然而，男性和女性之间的“正常”范围在积液方面相似（0-10.3mm 对 0-9.8mm），但在滑膜增生方面不同（0-6.8mm 对 0-5.4mm）。健康对照组中的彩色多普勒信号（PDS）很少见（男性 1.2%，女性 0.0%）。男性的最佳截点为 7.4mm，女性为 5.3mm，用于积液，分别为 3.7 和 1.6 用于增生。男性和女性的高特异性截点分别为 8.9 和 7.8 用于积液，分别为 5.8 和 4.2 用于增生。
在没有疼痛性膝 OA 的社区人群中，US 积液和滑膜增生很常见，但因性别而异。目前用于异常的切点需要重新评估。
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