Ultrasonography findings in knee osteoarthritis: a prospective observational cross-sectional study of 100 patients

Claudia Andreia Rabay Pimentel Abicalaf,Felipe Ricardo Aquino Dos Santos,Leticia Naomi Nakada,Ichiro Akiho,Artur Cesar Aquino Dos Santos,Linamara Rizzo Battistella,Marta Imamura

doi:10.1038/s41598-021-95419-3

Claudia Andreia Rabay Pimentel Abicalaf, Felipe Ricardo Aquino Dos Santos + Show 5 more

Open Access

https://doi.org/10.1038/s41598-021-95419-3

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Abstract

Worldwide, knee osteoarthritis (KOA) accounts for 2.2% of total years lived with disability. There is a low correlation between joint tissue damage and pain intensity. Periarticular structures may be involved and cannot be identified in X-rays. To describe the main ultrasonography (USG) changes in symptomatic patients with primary KOA; to correlate the number of USG findings with KOA severity assessed by Kellgren and Lawrence (K&L) radiological scores, with pain intensity measured by a visual analogue scale (VAS) and with functioning scores assessed with the Timed up and go test (TUG) and Western Ontario and McMaster Universities (WOMAC) questionnaire. 100 patients with primary symptomatic KOA were assessed with X-ray and USG. Quantitative and qualitative analyses were evaluated in a systematic manner. The most frequent findings were joint effusion, pes anserinus bursitis, quadriceps tendon enthesopathy, popliteal cyst, iliotibial band tendinitis and patellar tendinitis. Pearson’s correlation analysis demonstrated a significant moderate positive association between VAS scores and the number of USG findings (r = 0.36; p < 0.0001). The number of USG findings was different between K&L grades I and III (p = 0.041), I and IV (p < 0.001), and II and IV (p = 0.001, analysis of variance with Bonferroni correction). There was significant association between number of USG findings and TUG (r = 0.18; p = 0.014) and WOMAC scores for pain (r = 0.16; p < 0.029) and physical function domains (r = 0.16; p < 0.028). The most frequent USG finding was joint effusion. Periarticular structures should be explored as potential sources of pain and disability.

Highlights

Worldwide, knee osteoarthritis (KOA) accounts for 2.2% of total years lived with disability
The objectives of our study were to describe the main USG changes in symptomatic patients with primary KOA; to correlate the number of USG changes and the severity of the X-ray findings using the Kellgren and Lawrence (K&L) radiological scores; and to determine if there is a significant correlation between the number of the USG changes and the pain intensity measured by a visual analogue scale (VAS) and functioning scores assessed with Timed up and go test (TUG) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires
Together with the high prevalence of USG findings, we identified a significant positive correlation between the number of USG findings and pain intensity scores measured by a VAS

Summary

Introduction

Knee osteoarthritis (KOA) accounts for 2.2% of total years lived with disability. To describe the main ultrasonography (USG) changes in symptomatic patients with primary KOA; to correlate the number of USG findings with KOA severity assessed by Kellgren and Lawrence (K&L) radiological scores, with pain intensity measured by a visual analogue scale (VAS) and with functioning scores assessed with the Timed up and go test (TUG) and Western Ontario and McMaster Universities (WOMAC) questionnaire. Musculoskeletal disorders are the group that most contribute to the need for rehabilitation, due to their high prevalence and contribution to total years lived with d isability[1] Among these disorders, knee osteoarthritis (KOA) is a leading cause of disability in the elderly population and a common health condition in this population[2]. There is remaining controversy about the existence of correlations between USG findings, Kellgren and Lawrence (K&L) grades[14], pain scores and functionality in previous studies[10,11,13,15]

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