الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 66 |  |  |
| | | from | 66 | | |
Abstract
Primary knee osteoarthritis (KOA) is more common in females owing to many factors including increased Q-Angle. The quadriceps angle, or Q-angle, is an important biomechanical factor in assessing the knee joint function. It’s defined as the angle formed between a line representing the resultant line of force of the quadriceps muscle, and the longitudinal line from the midpoint of the patella to the tibial tubercle. An increase in Q-angle above the normal range is considered as misalignment of extensor mechanism, and associated with many disorders like patellofemoral pain syndrome, patellar instability, hypermobility of knee joint, and degenerative knee disorders. Studying the complex biomechanics of the knee joint is essential to diagnose and hence properly treating joint pathology conservatively with simple methods as knee muscle strengthening exercises, modified footwear, knee braces and weight loss.
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 this work was to study the relation between Q-Angle and clinical, radiographic and musculoskeletal ultrasonographic (US) findings in female patients with symptomatic primary KOA.
This study had included twenty-five female patients with a mean age of 55.7±4.01 years ranged from 47 to 62 years fulfilling ACR criteria for KOA. Patients were clinically assessed with calculation of the Western Ontario and Mcmaster Universities Arthritis (WOMAC) index as a functional score. They underwent knee musculoskeletal US examination for evaluation of medial, lateral and inter-condylar distal femoral cartilage thickness and grading. Also conventional radiography of knees were scored using the Kellgren-Lawrence (K-L) grading scale.
The mean Q-Angle measurement was 18.3 ± 1.99⁰. The mean duration of KOA symptoms was (4.86± 3.4 years). The mean total WOMAC score was 63.4 ± 10.4. Radiologically, using K- L scale, 50% of the knees were grade three and 50% were grade four. The mean thicknesses of the US-measured articular cartilage of the medial, lateral and inter-condylar area were 2.11 ± 0.52 mm, 2.13 ± 0.48 mm, and 2.69 ± 3.40 mm, respectively. The percent of studied knees was (2%,24%, 28%, 16%, 20% and 10%) on US grading ranged from grade zero to five respectively. A positive correlation was found between the mean Q-Angle value and the mean duration of disease and crepitus (r=0.286, p=0.044; r= -2.250, p= 0.024), respectively and a negative correlation was found with total WOMAC Score (r=-0.367, p=0.009). However, no significant relation was observed between the Q-Angle and other clinical and imaging findings (p>0.05).