Diagnostic and score value of ultrasound and magnetic resonance imaging in hemophilia arthropathy

Abstract

Objective To explore the diagnostic and score value of ultrasound on hemophiliac arthropathy, referring to MRI on the diagnosis and score of hemophiliac arthropathy. Methods The ultrasound and MRI examinations were performed on 42 joints of 42 hemophilia patients(14 knees, 14 ankles and 14 elbows). The consistency of ultrasound and magnetic resonance imaging in the detection and score of joint diseases was compared. Finally, inter- and intra-observer agreement of ultrasound scoring system were tested. Results The consistency of ultrasound and magnetic resonance imaging was excellent (κ=0.763-0.896, P<0.001) in the detection of early soft tissue lesions (effusion or hemarthrosis, synovial hypertrophy, hemosiderin), excellent (κ=0.793, P<0.001) in the detection of cartilage loss, poor (κ=0.133, P=0.132) in the detection of erosions and poor (κ=0.100, P=0.137) in the detection of subchondral cysts.The consistency of ultrasound and magnetic resonance imaging was good to excellent (κ=0.684-0.833, P<0.001) in the score of early soft tissue lesions (effusion or hemarthrosis, synovial hypertrophy and hemosiderin) and poor to good (κ=0.145-0.635, P<0.001) in the score of advanced osteochondral lesions (cartilage loss and bone erosions). The inter-observer agreement was good to excellent (κ=0.676-0.870, P<0.001) for early soft tissue lesions and moderate to excellent (κ=0.421-0.751, P<0.001) for advanced osteochondral lesions. The intra-observer agreement was good to excellent (κ=0.705-0.885, P<0.001) for early soft tissue lesions and moderate to good (κ=0.532-0.732, P<0.001) for advanced osteochondral lesions. Conclusions Ultrasound plays an important role in detecting early soft tissue changes (effusion or hemarthrosis, synovial hypertrophy, hemosiderin) and cartilage loss, which helps follow-up and guide clinical treatment. Key words: Ultrasonography; Hemophilia; Joint diseases; Magnetic resonance imaging