Diagnostic value of biplanar ultrasonographic assessment in detecting degenerative changes in femoral articular cartilage

Yıl 2019, Cilt: 10 Sayı: 2, 179 - 183, 12.06.2019

Meltem Özdemir , Rasime Pelin Kavak

https://doi.org/10.18663/tjcl.482452

Öz

Aim: The aim of our study was to assess the diagnostic
value of biplanar ultrasonography in detecting degenerative changes of femoral
articular cartilage using magnetic resonance imaging as the reference method.

Material
and Methods: Femoral articular cartilage examination was performed
with ultrasonography and magnetic resonance imaging in 40 patients with knee
pain. Magnetic resonance imaging of the knees were carried out on a 1.5 T scanner with proton density weighted,
fat suppressed sequence in three
orthogonal planes. Ultrasonographic evaluations of the knees were performed in
both longitudinal and transverse planes. Taking the findings of magnetic
resonance imaging as a reference, the
diagnostic effectiveness of biplanar US in detecting medial condylar, lateral
condylar and intercondylar notch cartilage lesions were calculated.

Results: The sensitivity of biplanar ultrasonography in
detecting medial condylar, lateral condylar, and intercondylar notch cartilage
lesions were 93.55%, 61.11%, and 53.85%, respectively. The specificity of the
technique in detecting the lesions in these locations were 88.89%, 90.91%, and     100.00%, respectively.

 Conclusion: Ultrasonography is a
relatively inexpensive, easily accessible and a non-invasive imaging tool. We
found that biplanar ultrasonography is a reliable method in detecting medial
condylar cartilage lesions in knee osteoarthritis, and we recommend using it
for the purposes of screening and follow-up evaluation of medial type knee
osteoarthritis where MRI is not accessible.

Anahtar Kelimeler

knee osteoarthritis, cartilage degeneration, ultrasonography

Biplanar ultrasonografik incelemenin femoral artiküler kıkırdaktaki dejeneratif değişiklikleri saptamadaki tanı değeri

Öz

Amaç: Manyetik rezonans görüntüleme referans alınarak,
transvers ve longitudinal yaklaşımların beraber kullanıldığı biplanar
ultrasonografik incelemenin, femoral artiküler kıkırdaktaki dejeneratif
değişiklikleri saptamadaki tanı değerinin saptanması amaçlandı.

Gereç
ve Yöntemler: Diz ağrısı
şikayeti olan 40 hastada ultrasonografi ve manyetik rezonans görüntüleme ile
femoral artiküler kıkırdak incelemesi yapıldı. Manyetik rezonans görüntüleme,
1.5 T görüntüleyicide her üç ortogonal düzlemde proton dansite ağırlıklı sekans
kullanılarak uygulandı. Diz ultrasonografi incelemesi, transvers ve
longitudinal planlarda gerçekleştirildi. Manyetik rezonans görüntüleme
bulguları referans alınarak biplanar diz ultrasonografi incelemesinin medial
kondil, lateral kondil, ve interkondiler çentik lokalizasyonlarındaki kıkırdak
lezyonlarını saptamadaki tanısal etkinliği hesaplandı.

Bulgular: Biplanar ultrasonografinin medial kondil, lateral
kondil, ve interkondiler çentik lokalizasyonlarındaki lezyonları saptamadaki
sensitivitesi aynı sıra ile %93,55, %61,11 ve %53,85, ve spesifisitesi aynı
sıra ile %88,89, %90,91 ve %      100,00
bulundu.

Sonuç:
Ultrasonografi
nispeten ucuz, kolay ulaşılabilir ve noninvaziv bir inceleme yöntemidir.  Biplanar ultrasonografi tekniğinin diz
osteoartritindeki medial kondiler kıkırdak lezyonlarını saptamada güvenilir bir
inceleme metodu olduğunu saptadık ve medial tip diz osteoartriti taraması ve MRG
erişiminin kısıtlı olduğu durumlarda takip değerlendirmesinde kullanımını
öneriyoruz.

Anahtar Kelimeler

diz osteoartriti, kıkırdak dejenerasyonu, ultrasonografi

Kaynakça

• 1. Oo WM, Bo MT. Role of ultrasonography in knee osteoarthritis. J Clin Rheumatol 2016; 22: 324-29.
• 2. Bruyn GAW, Naredo E, Damjanov N et al. An OMERACT reliability exercise of inflammatory and structural abnormalities in patients with knee osteoarthritis using ultrasound assessment. Ann Rheum Dis 2016; 75: 842-46.
• 3. Chan KK, Sit RW, Wu RW, Ngai AH. Clinical, radiological and ultrasonographic findings related to knee pain in osteoarthritis. PLoS One 2014; 9: 92901.
• 4. Malas FÜ, Kara M, Kaymak B, Akinci A, Özçakar, L. Ultrasonographic evaluation in symptomatic knee osteoarthritis: clinical and radiological correlation. Int J Rheum Dis 2014; 17; 536–40.
• 5. Mortada M, Zeid A, Al-Toukhy M et al. Reliability of a Proposed Ultrasonographic Grading Scale for Severity of Primary Knee Osteoarthritis. Clin Med Insights Arthritis and Musculoskelet Disord 2016; 9: 161- 66.
• 6. Saarakkala S, Waris P, Waris V et al. Diagnostic performance of knee ultrasonography for detecting degenerative changes of articular cartilage. Osteoarthritis Cartilage 2012; 20: 376–81.
• 7. Abraham AM, Goff I, Pearce MS, Francis RM, Birrell F. Reliability and validity of ultrasound imaging of features of knee osteoarthritis in the community. BMC Musculoskelet Disord 2011; 12: 70.
• 8. Riecke BF, Christensen R, Torp-Pedersen S, Boesen M, Gudbergsen H, Bliddal H. An ultrasound score for knee osteoarthritis: a cross-sectional validation study. Osteoarthritis Cartilage 2014; 22: 1675–91.
• 9. Podlipska J, Guermazi A, Lehenkari P et al. Comparison of diagnostic performance of semi-quantitative knee ultrasound and knee radiography with MRI: Oulu Knee Osteoarthritis Study. Scientific Reports 2016; 6: 22365
• 10. Yoon CH, Kim HS, Ju JH, Jee WH, Park SH, Kim HY. Validity of the sonographic longitudinal sagittal image for assessment of the cartilage thickness in the knee osteoarthritis. Clin Rheumatol 2008;27:1507–1516.
• 11. Guermazi A, Hayashi D, Eckstein F, Hunter DJ, Duryea J, Roemer FW. Imaging of osteoarthritis. Rheum Dis Clin North Am 2013; 39: 67–105.
• 12. Hunter DJ, Zhang YQ, Tu X, Lavalley M et al. Change in joint space width: hyaline articular cartilage loss or alteration in meniscus? Arthritis Rheum 2006; 54: 2488–95.
• 13. Cao J, Zheng B, Meng X, Lv Y, Lu H, Wang K, Huang D, Ren J. A novel ultrasound scanning approach for evaluating femoral cartilage defects of the knee: comparison with routine magnetic resonance imaging. J Orthop Surg Res 2018; 13: 178.
• 14. Asano T, Akagi M, Koike K et al. In vivo three-dimensional patellar tracking on the femur. Clin Orthop Relat Res 2003; 413: 222-32.
• 15. Low P, Roques A, Taylor A et al. Patella shift measurements during knee flexion. 52nd Annual Meeting of the Orthopaedic Research Society. [abstract] Paper No: 0532.