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比较X线摄影与超声检查在膝关节骨关节炎检测中的准确性:一项诊断性研究。

Comparing the Accuracy of Radiography and Sonography in Detection of Knee Osteoarthritis: A Diagnostic Study.

作者信息

Majidi Hadi, Niksolat Fatemeh, Anbari Khatereh

机构信息

Department of Radiology, Faculty of Medicine, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.

Department of Rheumatology, Faculty of Medicine, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.

出版信息

Open Access Maced J Med Sci. 2019 Dec 5;7(23):4015-4018. doi: 10.3889/oamjms.2019.617. eCollection 2019 Dec 15.

Abstract

BACKGROUND

Knee osteoarthritis (OA) is the most common degenerative disorder occurring in older people. Radiography and sonography are convenient techniques to detect diverse pathological features of knee OA.

AIM

The aim of the present study was to evaluate the diagnostic efficacy of radiography and sonography in the detection of diverse features of knee OA.

METHODS

In a prospective cross-sectional diagnostic accuracy study, 50 consecutive patients with suspected knee OA (40 women and 10 men, mean age 41.2 ± 6.1 years), referred to the rheumatology clinic of the Shohada Hospital of Khorramabad. All obtained magnetic resonance imaging (MRI), radiographic and sonography images were evaluated by two radiologists and rheumatologist with sufficient expertise in degenerative knee disorders. MRI has been considered as a gold standard test in evaluating other tests. The sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV) and accuracy with 95% confidence intervals of radiography and sonography in the diagnosis of knee OA were calculated.

RESULTS

Prevalence of the marginal osteophyte, geode and decreased joint thickness were significantly higher in patients with age > 40 years compared to ≤ 40 years (P < 0.05). The incidence of diverse features of knee OA was not significantly different in terms of the patient's gender, except for decreased joint space. The specificity of radiography was higher than its sensitivity.

CONCLUSION

Our study showed that both radiography and sonography are useful imaging modalities, especially to diagnosis the positive cases of knee OA. The specificity of radiography is higher than to its sensitivity for all pathological features of knee OA. The sensitivity of sonography to detect some features of knee OA such as decreased joint thickness is considerably higher than radiography.

摘要

背景

膝关节骨关节炎(OA)是老年人中最常见的退行性疾病。X线摄影和超声检查是检测膝关节OA多种病理特征的便捷技术。

目的

本研究旨在评估X线摄影和超声检查在检测膝关节OA多种特征方面的诊断效能。

方法

在一项前瞻性横断面诊断准确性研究中,连续纳入50例疑似膝关节OA的患者(40例女性和10例男性,平均年龄41.2±6.1岁),这些患者被转诊至霍拉马巴德烈士医院的风湿病诊所。所有获得的磁共振成像(MRI)、X线摄影和超声检查图像均由两名在膝关节退行性疾病方面具有足够专业知识的放射科医生和风湿病学家进行评估。MRI被视为评估其他检查的金标准检查。计算了X线摄影和超声检查在诊断膝关节OA时的敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)以及95%置信区间的准确性。

结果

年龄>40岁的患者边缘骨赘、骨囊肿和关节间隙变窄的患病率显著高于年龄≤40岁的患者(P<0.05)。除关节间隙变窄外,膝关节OA多种特征的发生率在患者性别方面无显著差异。X线摄影的特异性高于其敏感性。

结论

我们的研究表明,X线摄影和超声检查都是有用的成像方式,尤其是用于诊断膝关节OA的阳性病例。X线摄影对膝关节OA所有病理特征的特异性高于其敏感性。超声检查检测膝关节OA某些特征(如关节间隙变窄)的敏感性明显高于X线摄影。

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