The importance of using ultrasonography in knee osteoarthritis

Abstract

Radiographic features of osteoarthritis (OA) do not correlate with its symptoms at the individual patient level; thus, conventional radiography has limitations. Ultrasonography plays an important role in the diagnosis of musculoskeletal disorders. It reveals soft-tissue abnormalities such as pes anserine bursitis, Baker’s cyst, effusion, synovial hypertrophy, meniscal tear, and collateral ligament injury. The aim of this study was to detect changes in the knee that cannot be visualized using conventional radiography and to better understand and manage unexplained pain in OA. There was a discrepancy between the results obtained by clinical examination and those by ultrasonography. Knee effusion was found in 21 knees (70%); synovial hypertrophy was found in three knees (10%), of them two showed Baker’s cyst and marked effusion; Baker’s cyst was found in eight knees (27%); and pes anserine bursitis was found in one knee. Results that could not be found by clinical examination were: cartilage degeneration in 27 knees (90%) and meniscal degeneration in 26 (86%). Meniscal degeneration and synovial hypertrophy were correlated significantly with advanced cartilage degeneration (P < 0.001). Ultrasonography can be used for diagnosing soft-tissue lesions, for grading the severity of OA, and for guiding and monitoring therapy.