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Abstract
Osteoarthritis is the most common form of joint disease. It is strongly age related, additional risks include family history, female sex and obesity. The term osteoarthritis describes a heterogeneous group of common conditions with similar pathological and radiological features and it is classified as a disorder of synovial joints. Knee osteoarthritis is strongly associated with women and obesity. Cardinal symptoms of osteoarthritis include use related pain, short lasting stiffness especially in the morning and crepitus. Examining an affected knee with osteoarthritis; mild to moderate firm swelling around the joint line is present which is usually due to formation of osteophytes at the joint margin and these may be tender. Tenderness may also be felt over the joint line as well as crepitus on movement and restricted range of motion. Plain radiograph has been always the investigation most frequently used to confirm the clinical diagnosis; yet, musculoskeletal ultrasound has been increasingly utilized in patients with early osteoarthritis due to its ability to detect with greater sensitivity than plain films as well as its ability to visualize the synovium and adjacent soft tissue structure. Moreover, they are mostly used as routine examination. The aim of our study was to assess the correlation between functional evaluation, severity and ultrasonographic findings in knee osteoarthritis. Thirty patients presenting with primary OA of the knee joint were enrolled in this study and twenty healthy adults as control, for detecting joint inflammatory changes as synovial effusion, synovial thickening, articular cartilage erosions , osteophytes and joint space narrowing. Ultrasound was assessed in both knees, subclinical sonographic effusion and synovial thickening were detected in most of the studied patients. Articular cartilage erosions and joint space narrowing were also detected by ultrasound. Statistically significant correlation was detected between clinical and ultrasound indices regarding; joint effusion, synovial thickening, articular cartilage erosion and joint space narrowing. This has been proven in other studies as well. On correlating OARSI-OMERACT Initiative New OA Pain Measure with clinical and ultrasonographic findings, there was a statistically significant correlation between constant pain score and US narrowing, synovitis, clinical effusion and ROM limitation. Statistically there was significant difference between constant pain score and clinical tenderness and clinical effusion. In conclusion, musculoskeletal ultrasonography is a very useful tool in assessing osteoarthritic changes of the knee early during the course of the disease, which allows the treating doctor to interfere in the proper time and use the suitable management and medications to prevent disease progression.