Ultrasonographic findings in young adult patients with early osteoarthritis (OA) of the knee. Preliminary data.

Abstract

Purpose: Introduction. The OA is a chronic and multi-factorial disease; it is characterized by gradual loss of articular cartilage. The accepted method for assessing and doing OA diagnosis is a conventional radiography. When the clinicians assessed a knee radiography and give a diagnosis of OA, maybe it is late, because the patients have some months or years that started the degenerative process in cartilage. In recent years the musculoskeletal ultrasound (MSUS) has been used to obtain data about late knee OA, however there are few article published, which described morpho-structural changes in the MSUS in patients with early knee OA. Objectives: To estimate the prevalence of morpho-structural changes (presence of synovitis, effusion, osteophytes and meniscal extrusion) using MSUS in early knee OA patients. Evaluate the relationship between these ultrasound findings and quality of life and function in knee OA patients. Methods: Patients and Methods: We used preliminary data from the study of the impact of metabolic syndrome (MS) in patients with OA, which is carried out at the National Institute of Rehabilitation. Briefly, inclusion criteria: adult patients under 55 years of age and criteria for knee OA from the ACR and the radiography score 1 to 2 of Kellgren and Lawrence classification. Patients with autoimmune inflammatory diseases, fibromyalgia, illness crystals and previous surgery were excluded. All patients underwent to knee MSUS to evaluate the presence of synovitis, effusion, osteophytes and meniscus extrusion. Epidemiological data were collected from patients, the EuroQoL were used to evaluate the quality of life and WOMAC scale was applied to evaluate the knee function. The results were analyzed using descriptive and bivariate test, parametric and no-parametric statistical tests were used. Results: We studied 72 patients, mean age 45 years ± 7.4, 83% female gender, education (years) mean 10.5 ± 3.8, Body Mass Index 30.6 ± 4.9. Score for WOMAC were: pain 1.4, stiffness 1.5, physical function 1.3. EuroQol 0.55 in male population vs. 0.69 in women population. The table 1 show MSUS findings. Conclusions: morpho-structural findings by MSUS were found in a high prevalence of patients with knee OA classified by radiology in early stages. This shows that although radiology is the most used method for classification of disease, it does not evaluate an early OA, further studies are required to detect early changes of OA.Table IPrevalence of musculoskeletal ultrasound findings in OA patientsUltrasound knee siteSynovitis % (mm)MeniscusExtrusion % (mm)Site of OsteophytesMedial / Lateral(%)SP* Right18 (7.9)Medial Right8 (2.8)Femoral Right35 / 63SP* Left28 (8.2)Medial Left6 (3.8)Femoral Left63 / 63Medial Right20 (4.3)Lateral Right19 (3.6)Tibial Right46 / 63Medial Left20 (4.1)Lateral Left19 (3.4)Tibial Left57 / 63Lateral Right48 (4.6)Lateral Left43 (4.2) Open table in a new tab