X-RAY CHARACTERISTICS OF THE KNEE JOINTS IN PATIENTS WITH MONOGONATHROSIS

Abstract

Introduction. The feasibility of X-ray examination in the diagnosis of gonarthrosis in the knee joint has been increasingly questioned in recent years due to the impossibility of visualizing soft tissue elements; instead, magnetic resonance imaging as a priority method of radiation diagnostics is considered as more appropriate. The goal of this study is to investigate the structural and functional state of the knee joints of patients with monogonarthrosis by comparing the findings obtained by standard X-ray and magnetic resonance imaging. Material and methods. Materials included clinical and radiological examination protocols of 125 patients (54 (43.2%) men and 71 (57.8%) women), aged from 18 - 79 years with monogonarthrosis. Research methods included the clinical assessment of orthopaedic status; X-ray diagnostics: X-ray examination of knee joints with the evaluation of qualitative and quantitative parameters of bone elements; magnetic resonance imaging with a study of the frequency of changes in soft tissues; biochemical investigation of blood serum with determining the C-reactive protein content, which was used as a serological marker of inflammation, and synovial fluid to assess the content of rheumatoid factor; obtained findings were processed statistically. Results and discussion. According to the results of the comprehensive examination, group A with primary monogonarthrosis (118; 94.4%) and group B with gray-positive unspecified rheumatoid monoarthritis (7; 5.6%) were identified. Group A was divided into 2 subgroups: seronegative A1 (71; 56.8%) with normal CRP content and seropositive A2 (47; 37.6%) with CRP > 5 mg/l. Qualitative and quantitative X-ray signs of knee joints in the patients with monogonarthrosis grade 1-2 according to the Kellgren-Lawrence classification revealed asymmetry of the width of the condyles of the femur (81.6%) and tibia (86.4%), asymmetry of the joint space (89.6%) and discordance of joint surfaces (88.8%). MRI scans of the affected knee joint demonstrated a high frequency of synovitis (98.4%), hypertrophy of Hoff fat bodies (92.0%), degenerative lesions of the medial (22.4%) and both (65.6%) menisci, chondromalacia of the patella ( 68.8%), osteophytes (64%), and incomplete rupture of the anterior cruciate ligament (64.8%). In subgroups A1 and A2, the X-ray anatomical structure of the knee joints was almost identical without statistical difference in any of the studied parameters. Conclusion. Standard radiography of the knee joint in patients with monogonarthrosis enables to assess the anatomobiomechanical characteristics of the bone elements of the knee joint. According to the MRI results, it is possible to assess the state of the soft tissue components in the knee joint. These imaging techniques complement each other and, to some extent, help to predict the further course of the disease.