Diagnostic Value Of High-frequency Ultrasound In Synovial Diseases Of Knee Joint

ObjectiveTo evaluate the diagnostic value of high - frequency ultrasound in synovial diseases of the knee joint compared with the results of arthroscopy.To analyze joint effusion and synovial tissue thickness of synovial diseases of knee joint and to correlate joint effusion with synovial tissue thickness.To analyze the value of three - dimensional ultrasound imaging in synovial diseases of suprapatellar bursa and to provide preliminary types of three - dimensional ultrasound.Materials and methodsPatients. Thirty - eight patients with 42 knee joints were examined with high - frequency ultrasound before arthroscopy during a period of 17 months, from July, 2003 to December, 20024 The 38 patients were recruited from First Affiliated Hospital of China Medical University during their initial visit (16 female, 22 male, mean age 36 years old, range from 17 to 58 years old). In addition , thirteen patients from out - patient clinic and hospital room with rheumatoid arthritis (RA) (n =6) , osteoarthritis (OA) (n =5) and gout (n =2) during following visits (6 female, 7 male, mean age 42 years old, range from 16 to 72 years old).Ultrasound examination. The studies were performed using a linear array transducer with frequency 7-12 MHz (Philips ATL - HDI 5000 SonoCT, Washington USA).Each knee joint was scanned longitudinally and transversely from the front view,with the joint in 45°of knee flexion. The joints were documented in longitudinal and transverse view in B mode, color mode and three - dimensional ultrasound mode. Data were saved in a digital archiving computer system (Lanyun, Shenzhen, China).Statistical analysis. The results of joint effusion in different synovitis subgroups were compared by unpaired t - test. The same approach was used to compare the thickness of synovial tissue between the different synovitis subgroups. The correlations between joint effusion and synovium thickness were analyzed by Pearson correlation tests.The diagnostic ability of high - frequency ultrasound in synovial diseases of knee joints was evaluated by sensitivity, specificity, accuracy, positive predictive value and negative predictive value.ResultsHigh - frequency ultrasound and arthroscopy. Arthroscopy and histopathol-ogy diagnosed 36 synovial diseases of knee joints, which consisted of chronic synovitis( n = 16) , trauma synovitis (n = 12) , synovium chondromatosis ( n = 5 ) , pigmented villonodular synovitis ( n = 2) and synovium hemangioma ( n =1).Hie coincidence rate between the findings of high - frequency ultrasound and the results of arthroscopy and histopathology was 78.6% (33/42).For the synovial diseases of the knee joint with high - frequency ultrasound , the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 94.4% , 83. 3% , 92. 9% , 97. 1% and 62. 5% respectively.Joint effusion and synovial tissue thickness. Joint effusion was found in 93.3% (56/60) patients with synovial diseases of knee joint. Five main different sonographic patterns of joint effusion were detected;(l)Anechoic ( n = 44) : increasing amount of homogeneous anechoic synovial fluid.(2)Cloudy (n =7) : multiple isoechoic dots (7 out of 12 patients with trau-...