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膝骨关节炎患者的超声检查结果:与临床特征、影像学表现及全身性骨关节炎的关系

Ultrasound findings in patients with knee osteoarthritis: Relationships with clinical characteristics, radiographic findings and generalized osteoarthritis.

作者信息

Sumen Ahmet, Kurt Oktay Kubra Neslihan

机构信息

BAM Private Physical Medicine and Rehabilitation Clinic, Istanbul, Turkey.

University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey.

出版信息

Osteoarthr Cartil Open. 2025 Jul 30;7(3):100656. doi: 10.1016/j.ocarto.2025.100656. eCollection 2025 Sep.

Abstract

OBJECTIVE

To evaluate the relationship between ultrasound (US) findings and radiographic Kellgren-Lawrence (K/L) grades, symptom severity, and the presence of generalized osteoarthritis (GOA) in patients with knee osteoarthritis (OA), and to identify key US parameters associated with OA severity.

METHODS

This cross-sectional study included 166 patients (332 knees) with radiographically confirmed knee OA. US assessments included medial and lateral meniscus extrusion (MME, LME), suprapatellar effusion, synovitis, femoral cartilage thickness (FCT), femoral cartilage lesions, Baker's cyst, pes anserine bursitis, patellar tendinopathy, and Hoffa's fat pad pathology. K/L grades were determined by radiography. Pain and function were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). GOA was defined as OA in five or more joints or the presence of Heberden's nodes with additional joint involvement.

RESULTS

MME showed a strong correlation with K/L grade (r ​= ​0.954, p ​< ​0.001), with 91.57 ​% exact agreement. LME showed a moderate correlation (r ​= ​0.693, p ​< ​0.001). GOA was identified in 12.65 ​% of patients and was independently associated with lower BMI, reduced FCT (<2 ​mm), and the presence of femoral cartilage lesions. Moderate correlations were observed between K/L grade and pain, WOMAC scores, and symptom duration

CONCLUSION

MME and FCT measured by US are strong indicators of OA severity and may help identify patients at risk for GOA. US appears to be a practical, radiation-free tool for assessing and monitoring OA progression. Further validation in larger cohorts is recommended.

摘要

目的

评估膝关节骨关节炎(OA)患者的超声(US)检查结果与放射学凯尔格伦-劳伦斯(K/L)分级、症状严重程度及全身性骨关节炎(GOA)之间的关系,并确定与OA严重程度相关的关键US参数。

方法

这项横断面研究纳入了166例(332膝)经放射学确诊的膝关节OA患者。US评估包括内侧和外侧半月板挤出(MME、LME)、髌上囊积液、滑膜炎、股骨软骨厚度(FCT)、股骨软骨损伤、贝克囊肿、鹅足滑囊炎、髌腱病变和霍法脂肪垫病变。K/L分级通过放射学确定。使用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评估疼痛和功能。GOA定义为五个或更多关节存在OA或伴有其他关节受累的赫伯登结节。

结果

MME与K/L分级呈强相关(r = 0.954,p < 0.001),完全一致性为91.57%。LME呈中度相关(r = 0.693,p < 0.001)。12.65%的患者被诊断为GOA,且其独立相关因素为较低的体重指数、FCT降低(<2mm)和股骨软骨损伤的存在。K/L分级与疼痛、WOMAC评分和症状持续时间之间存在中度相关性。

结论

US测量的MME和FCT是OA严重程度的有力指标,可能有助于识别GOA风险患者。US似乎是一种用于评估和监测OA进展的实用、无辐射工具。建议在更大队列中进行进一步验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e20/12341512/439bb8304efd/gr1.jpg

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