الفهرس 
Musculoskeletal ultrasoundOnly 14 pages are availabe for public view
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Abstract
Osteoarthritis (OA) is a slowly progressing degenerative joint disease involving the cartilage and many of its surrounding tissues characterized by synovitis, cartilage degeneration, subchondral bone sclerosis, and osteophyte formation, knees are the most commonly affected joints by primary OA.
Pain, clinical effusions and Crepitus can be clinically evident in some joints with knee OA, and are observed using sensitive measures such as musculoskeletal ultrasound (MUS) and Magnetic resonance imaging (MRI).
Vascular endothelial growth factor (VEGF) is a signal protein produced by cells that stimulates the formation and permeability of blood vessels. VEGF is involved in both vasculogenesis (the de novo formation of the embryonic circulatory system) and angiogenesis (the growth of blood vessels from pre-existing vasculature).
Mechanical stress, inflammatory factors, and hypoxia induced chondrocytes to secrete VEGF and increased VEGF contributed to the formation of vascular arthritis, Color and power Doppler aid in identifying inflammatory conditions associated with increased vascularity or inflammatory reaction.
Our study aimed to correlate between Serum level of vascular endothelial growth Factor (VEGF) and Ultrasonography findings in Knee Osteoarthritis.
Our study included 30 patients with knee Osteoarthritis diagnosed according to ACR Clinical Classification Criteria for Osteoarthritis of the knee 1986 and 20 apparently healthy age and sex matched subjects from the hospital personnel and relatives of other patients was included as a control group, Patients were excluded if they have osteoarthritis 2ry to trauma or metablic disorder, inflammatory arthritis (RA, SLE, ect) , infectious arthritis (septic, viral or fungal) or knee joint replacement .
All patients were subjected to history taking and clinical examination. WOMAC, VAS and ICOAP tools were used for clinical assessment of knee joint. Laboratory investigations performed were ESR and vascular endothelial cell growth factor (VEGF) concentrations in serum.
MSUS was performed to patients and controls for assessing OA severity and power Doppler scores were a part of the assessment.
This study showed that, there was no statistically significant difference between cases and controls regarding sex and age, and showed obvious female predominance (75% female and 25% male). (3:1). the patients were in the age group of (35-45) years with Mean ±SD 37.7±3.93.
This study showed that, the overall mean BMI being 24.65±3.74, obesity and overweight have long been recognized as potent risk factors for OA, especially OA of the knee
Our study showed statistically highly significant correlation between VEGF and Doppler ultrasound signal (p <0.001) and statistically significant correlation between VEGF and (Synovial effusion, Synovial hypertrophy, Osteophytes) with p value (p=0.001, p=0.002 and p=0.002) respectively, There was no statistically significant correlation between VEGF and (Bursitis and Backer cyst) in studied cases.
There were statistically highly significant positive correlations between VEGF and (WOMAC, ICOP-total pain and VAS) with p value <0.001 and significant correlations between VEGF and (Early morning stiffness and ESR) with p value (0.001 and 0.01) respectively, On the other hand there were statistically significant negative correlations between VEGF and Cartilage thickness (mm) and statistically significant negative correlations between Cartilage thickness (mm) and other numerical data.
There were no statistically significant correlations between VEGF and BMI (kg/m2), Also There were no statistically significant correlations between Cartilage thickness (mm) and BMI (kg/m2 (.
There was statistically highly significant difference between cartilage thickness and (Synovial effusion, Osteophytes and Power Doppler signal) with (p<0.001) each and statistically significant difference between cartilage thickness and (Synovial hypertrophy and Backer cyst) with p=0.002 and p=0.02 respectively. There was no statistically significant difference between cartilage thickness and presence of bursitis in studied cases.
There was statistically Highly Significant correlation between VEGF and Doppler (p<0.001), also there was highly significant correlation between cartilage thickness and Doppler signal (p<0.001), more over there was statistically Significant correlation between cartilage thickness and Backer cyst (p=0.02). There was no statistically significant correlation between VEGF and (Synovial effusion, Synovial hypertrophy, Osteophytes or Baker cyst) or between cartilage thickness and (Synovial effusion, Synovial hypertrophy and Osteophytes) in studied cases.
There was statistically high significant difference between case groups (early, moderate and severe) regarding VEGF with p value<0.001 and There was statistically high significant difference between case groups (early, moderate and severe) regarding WOMAC “P-sub, S-sub, Pf-sub”, ICOP and VAS, also There was statistically significant difference between case groups (early, moderate and severe) regarding Early morning stiffness with p value 0.008,
There were statistically significant decrease in EMS (m), WOMAC p-sub, WOMAC s-sub, WOMAC pf-sub, ICOM-total pain and VAS among Early cases than Moderate cases and severe cases.
There were statistically high significant difference between case groups (early, moderate and severe) regarding Synovial effusion with p value <0.001, synovial hypertrophy with p value <0.001 and osteophytes with p value <0.001.
There were statistically significant maintenance of Cartilage thickness (mm) among early cases than Moderate cases and severe cases
There was no statistically significant difference between case groups (early, moderate and severe) regarding presence of Bursitis and Backer cyst.