Abstract
SummaryObjectiveTo establish “normal” ranges for synovial thickness and effusion detected by ultrasound (US) and to determine cut-offs associated with knee pain (KP) and radiographic knee osteoarthritis (RKOA) in the community.Methods147 women and 152 men ≥40 years old were randomly selected from the Nottingham KP and Related Health in the Community (KPIC) cohort (n = 9506). The “normal” range was established using the percentile method in 163 participants who had no KP and no RKOA. Optimal (maximum sensitivity and specificity) and high specificity (90%) cut-offs were established using receiver operating characteristic (ROC) curve analysis in a comparison between people with both KP and RKOA and normal controls.ResultsEffusion and synovial hypertrophy differed by gender but not by age or laterality, therefore gender-specific reference limits were estimated. However, the “normal” ranges between men and women were similar for effusion (0–10.3 mm vs 0–9.8 mm), but different for synovial hypertrophy (0–6.8 mm vs 0–5.4 mm). Power Doppler Signal (PDS) in the healthy controls was uncommon (1.2% in men and 0.0% in women). The optimal cut-off was 7.4 mm for men and 5.3 mm for women for effusion, and 3.7 and 1.6 for hypertrophy respectively. The high specificity cut-off was 8.9 for men and 7.8 for women for effusion, and 5.8 and 4.2 for hypertrophy respectively.ConclusionsUS effusion and synovial hypertrophy but not PDS are common, but differ by gender, in community-derived people without painful knee OA. Currently used cut-offs for abnormality need reappraisal.
Highlights
Knee osteoarthritis (OA) is a major cause of chronic pain and impaired function in older adults[1,2]
Apart from age, the healthy controls were different from symptomatic radiographic knee osteoarthritis (RKOA) for gender, body mass index (BMI), knee pain (KP), radiographic score and all three US features (Table I)
In the healthy controls both effusion and synovial hypertrophy did not associate with age (Appendix 7), but were greater in men than in women
Summary
Knee osteoarthritis (OA) is a major cause of chronic pain and impaired function in older adults[1,2]. Knee OA is a common complex joint disorder that involves all joint tissues including hyaline articular cartilage, fibrocartilaginous menisci, synovium, bone, ligaments and muscle3e5. These pathological changes can be detected a Joint senior authors. A. Sarmanova et al / Osteoarthritis and Cartilage 27 (2019) 435e443 histological findings[11,12] and correlates well with MRI in visualising effusion[13,14]. Evidence regarding “normal” values for effusion and hypertrophy in the general population is limited[15]. The only study to provide reference values for effusion was based on a group of healthy volunteers aged 20e60 years old (n 1⁄4 102)[16], which is a low age range for OA, and no population studies have reported normal values for synovial hypertrophy or prevalence of Power Doppler signal (PDS)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
