Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Cartilage. 2022 Jan-Mar;13(1):19476035221077403. doi: 10.1177/19476035221077403.
Radiographic changes in knee osteoarthritis (OA) are not always associated with symptoms, especially in its early stages. Ultrasonography (US) can detect early changes in the knee joint, but the changes that reflect symptoms have not been fully elucidated. This study aimed to identify US-detectable changes in the knee that are often associated with knee symptoms and demonstrate the feasibility of early diagnosis in symptomatic knee OA using US.
In this cross-sectional community-based study, 1,667 participants aged ≥60 years (1,103 women [66%]) were included. All participants concurrently underwent US and radiography of the knee and completed the Knee Society Knee Scoring System (KSS) questionnaire. Simple and multiple regression analyses were used to examine the associations between US findings and KSS symptom subscales.
Among all participants, medial meniscus protrusion and medial osteophytes, age, and body mass index showed significant associations with KSS symptom scores. Among 894 participants with Kellgren-Lawrence (KL) grade ≤1, medial osteophytes and age were significantly associated with KSS symptom score. US measures were more related to KSS symptoms than KL grades.
Among the knee US-detectable changes, medial osteophytes were strongly associated with knee symptoms. Osteophytes are reliable predictors of symptomatic early knee OA, even in participants with few radiographic OA changes.
膝关节骨关节炎(OA)的影像学改变并不总是与症状相关,尤其是在疾病早期。超声(US)可检测膝关节的早期变化,但反映症状的变化尚未完全阐明。本研究旨在确定与膝关节症状密切相关的膝关节 US 可见改变,并证明 US 对有症状的膝关节 OA 进行早期诊断的可行性。
在这项横断面社区基础研究中,纳入了 1667 名年龄≥60 岁的参与者(1103 名女性[66%])。所有参与者同时接受了膝关节 US 和 X 线摄影检查,并完成了膝关节学会膝关节评分系统(KSS)问卷。采用简单和多元回归分析来评估 US 发现与 KSS 症状子量表之间的关联。
在所有参与者中,内侧半月板突出和内侧骨赘、年龄和体重指数与 KSS 症状评分显著相关。在 894 名 KL 分级≤1 的参与者中,内侧骨赘和年龄与 KSS 症状评分显著相关。US 测量值与 KSS 症状的相关性高于 KL 分级。
在膝关节 US 可检测到的变化中,内侧骨赘与膝关节症状密切相关。骨赘是有症状的早期膝关节 OA 的可靠预测指标,即使在放射学 OA 改变较少的参与者中也是如此。