الفهرس 
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Abstract
Osteoarthritis is the most frequent disease of the musculoskeletal system. The knee is one of the most common joints involved in OA.
Plain radiography which is the primary imaging modality used to evaluate the OA, can assess bony abnormalities and indirect signs of articular cartilage lesion. However, it is unable to assess soft tissues involved in the pathophysiology of OA.
High-frequency musculoskeletal ultrasound is valuable during the early detection and monitoring progression of OA. In addition to non-invasiveness, it is quick to perform, relatively low cost, ability to scan multiple joints, repeatability, and high patient acceptability.
The aim of this study was to assess the role of ultrasound compared to X-ray in knee osteoarthritis.
The observational prospective for 50 knees of 50 patients with osteoarthritic knee symptoms were recruited for ultrasonography examination of the knee joint. The inclusion criteria denoted knee pain and knee joint limitation of movements, while the exclusion criteria encompassed trauma and previous knee surgery. They were 26 females and 24 males with ages ranged from 38 to 65 years with a mean of 55.96 years. 34 right knees representing (68%) and 16 left knees representing (32%).
All patients underwent ultrasonography of the knee joint using a linear high-frequency probe. The routine ultrasound examination of the knee started with its anterior aspect, followed by the medial, lateral and posterior aspects in both longitudinal and transverse planes.
Weight-bearing anteroposterior (AP) and lateral knee radiographs were done for all cases to assess the severity of OA and the presence of patellofemoral (PF) degenerative signs by using the Kellgren and Lawrence (K-L) scale (scores 0-4).
Results obtained from the ultrasonographic examination were compared to X-ray for each examined knee.
Ultrasonographic findings showed irregular articular surface and narrow joint space in 36 knees (72.0%), marginal osteophytes in 32 knees (64.0%), joint effusion in 44 knees (88.0%), decreased cartilage thickness in 16 knees (32.0%), synovial thickening in10 knees (20.0%), meniscal lesions in 35 knees (70.0%), Baker’s cyst in 10 knees (20.0%) and ligament injuries and tendon injuries in 12 knees (24.0%).
The K-L grading system of X-ray revealed: I in 18 knees (36.0%), II in 22 knees (44.0%), III in 10 knees (20.0%) knees, and IV in 0 knees (0.0%).We could also detect Patello-femoral (PF) degenerative signs in 34 knees (68.0%).
Both the ultrasound and X-ray could equally detect bony changes including irregular articular surface, narrow joint spacing, and marginal osteophytes with p-value>0.05; the value is considered a non-statistically significant difference. Further, six knees (12.0%) in X-ray inspection demonstrated joint effusion as detected in 44 knees (88.0%) by the US with p-value<0.001; that represents a highly statistically significant difference between the US and X-ray for detecting joint effusion. Other variables as decreased cartilage thickness, synovial thickening, meniscal lesions, Baker’s cyst, ligament injuries, and tendon injuries couldn’t be detected by the
X-ray (0.0%), but in our study have assessed clearly by the ultrasound with p-value<0.001 which was highly statistically significant difference.