Yates Katherine A, Alvarez Carolina, Schwartz Todd A, Savage-Guin Serena, Renner Jordan B, Bakewell Catherine J, Kohler Minna J, Lin Janice, Samuels Jonathan, Walker Tessa, Golightly Yvonne M, Nelson Amanda E
Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, and Ohio State University, Columbus.
Thurston Arthritis Research Center, University of North Carolina at Chapel Hill.
Arthritis Rheumatol. 2025 Feb 24. doi: 10.1002/art.43139.
Our study objectives were (1) to determine associations among ultrasound (US) features of knee osteoarthritis (KOA), radiographic KOA (rKOA), and patient-reported symptoms and (2) to determine diagnostic accuracy of US definitions for rKOA, in a community-based cohort.
Participants enrolled in the Johnston County Health Study (JoCoHS; 2019-2024, n = 902) provided demographics, comorbidities, clinical features, and symptoms, along with imaging with standardized acquisition and scoring protocols. Logistic regression models provided odds ratios adjusted for age, sex, race, ethnicity, body mass index (BMI), education level, comorbidities, and knee injury for associations among US features and KOA outcomes. Diagnostic accuracy was assessed using standard metrics with rKOA as the gold standard.
Complete imaging data were available for 861 participants (1,711 knees): 34% men, 25% Black, 10% Hispanic, mean age 55 years, and mean BMI 33. Half of knees were symptomatic, one-third had rKOA, and one in five had symptomatic rKOA. US-identified osteophytes, effusion, meniscal extrusion, cartilage damage, calcium crystals, and popliteal cysts were associated with KOA outcomes. A US definition including both mild osteophytes and mild cartilage damage gave an area under the receiver operating characteristic curve of 0.76 for diagnosing rKOA (validated in an external cohort).
We identified common US features in participants with and without KOA, along with significant associations between US features and rKOA, symptomatic rKOA, and symptoms. US-based diagnosis of rKOA shows promise for general use. US is a valuable and accessible modality for assessment of knee OA features in clinical and research settings, including those with limited resources.
我们的研究目的是：（1）确定膝关节骨关节炎（KOA）的超声（US）特征、放射学KOA（rKOA）和患者报告的症状之间的关联；（2）在一个基于社区的队列中确定US对rKOA定义的诊断准确性。
参加约翰斯顿县健康研究（JoCoHS；2019 - 2024年，n = 902）的参与者提供了人口统计学信息、合并症、临床特征和症状，以及采用标准化采集和评分方案的影像学检查。逻辑回归模型提供了针对年龄、性别、种族、民族、体重指数（BMI）、教育水平、合并症和膝关节损伤进行调整后的优势比，以分析US特征与KOA结局之间的关联。以rKOA作为金标准，使用标准指标评估诊断准确性。
861名参与者（1711个膝关节）有完整的影像学数据：男性占34%，黑人占25%，西班牙裔占10%，平均年龄55岁，平均BMI为33。一半的膝关节有症状，三分之一有rKOA，五分之一有症状性rKOA。US识别出的骨赘、积液、半月板挤出、软骨损伤、钙晶体和腘窝囊肿与KOA结局相关。一个包括轻度骨赘和轻度软骨损伤的US定义在诊断rKOA时，受试者工作特征曲线下面积为0.76（在外部队列中得到验证）。
我们在有和没有KOA的参与者中识别出常见的US特征，以及US特征与rKOA、症状性rKOA和症状之间的显著关联。基于US的rKOA诊断显示出有普遍应用的前景。在临床和研究环境中，包括资源有限的环境中，US是评估膝关节OA特征的一种有价值且可获得的检查方法。
