Department of Radiology, University of Health Sciences, Diskapi Yildirim Beyazit Health Application and Research Center, Ankara, Turkey.
J Ultrasound Med. 2019 Oct;38(10):2709-2719. doi: 10.1002/jum.14976. Epub 2019 Mar 4.
The aim of our study was to investigate the relationship between medial meniscal extrusion (MME) determined by dynamic ultrasound (US) and magnetic resonance imaging findings of medial-type knee osteoarthritis (OA).
Single knees of 102 patients with knee pain were assessed by radiography, dynamic US, and magnetic resonance imaging. All knee radiographs were interpreted and grouped according to the Kellgren-Lawrence (KL) scale. Medial meniscal extrusion in non-weight-bearing and weight-bearing positions and the difference of these values (ΔMME) were measured by dynamic US. The medial tibiofemoral compartments of all knees were evaluated and grouped according to the Whole-Organ Magnetic Resonance Imaging Score (WORMS). Mean values of non-weight-bearing MME, weight-bearing MME, and ΔMME ± standard deviations for groups formed according to the KL scale and WORMS system were compared.
We demonstrated that different from non-weight-bearing MME, weight-bearing MME was significantly correlated with not only high grades but also lower grades of cartilage damage and subchondral bone marrow lesions in medial-type knee OA. Although the difference in non-weight-bearing MME between cartilage status groups 1 and 2 was not significant (P = .071), there were significant differences in of weight-bearing MME between groups 1 and 2, between groups 2 and 3, and between groups 3 and group 4 (P = .003, .002, and .032, respectively).
We found statistically significant associations between MME values and the severity of the OA findings according to both the KL scale and WORMS system. We offer dynamic US as an initial tool for the diagnosis and a screening method to estimate the severity of knee OA.
本研究旨在探讨动态超声(US)检测的内侧半月板突出(MME)与内侧型膝骨关节炎(OA)的磁共振成像(MRI)表现之间的关系。
对 102 例膝关节疼痛患者的单膝进行 X 线摄影、动态 US 和 MRI 评估。所有膝关节 X 线片均根据 Kellgren-Lawrence(KL)分级进行解读和分组。在非负重和负重位测量内侧半月板突出,测量值的差值(ΔMME)。根据全器官 MRI 评分(WORMS)评估所有膝关节的内侧胫股关节间隙,并进行分组。比较 KL 分级和 WORMS 系统分组后非负重 MME、负重 MME 和 ΔMME(均为均值±标准差)的平均值。
与非负重 MME 不同,负重 MME 与内侧型膝 OA 中不仅较高等级,而且较低等级的软骨损伤和软骨下骨髓病变均显著相关。虽然在软骨状态组 1 和 2 之间,非负重 MME 的差异无统计学意义(P = .071),但在组 1 和 2 之间、组 2 和 3 之间以及组 3 和组 4 之间,负重 MME 的差异均有统计学意义(P = .003、.002 和.032)。
我们发现 MME 值与 KL 分级和 WORMS 系统的 OA 严重程度之间存在统计学显著关联。我们提供动态 US 作为诊断和筛查方法,以评估膝 OA 的严重程度。