Comparison Of Ultrasound Examination With DR And MRI In The Early Stage Of Knee Osteoarthritis

Research Background:China's aging population has become a growing trend,knee osteoarthritis(KOA)incidence increased year by year,which is now becoming common orthopaedic disease,senile group mainly has the clinical manifestations such as knee pain and restricted movement,the disease can appear serious knee varus or valgus deformity,which seriously affecting the body appearance,quality of life and patients' physical and mental health.The early stage of the disease usually has no obvious symptoms,and most patients are in the middle and late stage of the disease when they suffer from knee pain and dysfunction.Early diagnosis and timely measures to delay the development of the disease are the key to improve patients' quality of life.At present,imaging examination is the most common way to clinical diagnosis of knee osteoarthritis,The main methods are X-ray digital photography(DR),magnetic resonance imaging(MRI)and ultrasound examination,ultrasonic examination has no wound,no radiation damage and check quickly,wide scope and follow-up examination,and other advantages,can be in articular cartilage,synovial joints,tendons,ligaments,muscles and other pathological changes have important application value in diagnosis,and compared with DR,MRI,low cost,patients are more likely to accept,can understand the lesion therapeutic effect at any time.Objective:To explore the application value of ultrasonography in the early diagnosis of knee osteoarthritis and compare it with DR and MRI to provide the basis for the early diagnosis of knee osteoarthritis.Methods: A total of 60 cases of 120 knee joints,which were clinically diagnosed as knee osteoarthritis,were collected from February 2016 to December 2017 in the second affiliated hospital of zhengzhou university,and set as case group.All patients came to our hospital for treatment due to swelling and pain of knee joints and limited activity,which met the diagnostic criteria of osteoarthritis,and excluded patients with inflammatory or traumatic joint diseases such as rheumatoid arthritis and gout arthritis.All patients received ultrasound,DR,MRI examination,and the clinical data before and after surgery were complete.A total of 60 patients with 120 healthy knee joints were selected as the control group,all of whom had no history of knee swelling and pain,and had no symptoms or signs.Using Kazam ultrasonic rating,grading,Kellgren-Lawrence Recht standard MRI cartilage damage rating standard radiology imaging findings of patients with knee rating,by simulating the visual evaluation method(VAS),university of western Ontario and Mc Master knee osteoarthritis index(WOMAC)rating scale to assess the patient's clinical manifestations,appraise and compare the ultrasound,and DR rating clinical relevance.The diagnostic results of ultrasound,DR and MRI were compared,the advantages and disadvantages of ultrasound were compared,and the value of ultrasound in the early diagnosis of knee osteoarthritis was analyzed.Results:1 ? Normal control group of patients with knee joint ultrasonographic displayed patellar capsule on no or only a small amount of physiologic liquid.Both the internal free body and synovial thickness can be clearly displayed(synovial thickness < 2.5mm).The thickness of cartilage at the proximal end of femur can be displayed when the femur is placed in a cross-section position.The cartilage shows uniform low-echo light band with smooth edges and symmetrically inner and outer sides.2? The thickness is about 2mm.In the case group,ultrasonography showed suprapatellar bursa effusion(95 cases,including 92 cases with no echo in the suprapatellar sac,and 32 cases with no echo in the articular cavity)and synovial lesions(95 case),popliteal fossa cyst 108 cases,24 cases with irregular shape,downwards extends to the clearance of the gastrocnemius muscle),articular cartilage degeneration(106 cases,cartilage keyed uneven echo,clutter can be seen in the vocal cords and thinning,leading edge is not clear,some cases visible keyed vocal disappeared,leading edge blur),the subchondral bone destruction(62 cases),meniscus injury degeneration(48 cases),joint gap Narrows(86 cases),lateral collateral ligament injury(2 cases),cruciate ligament injury(2 cases),patellar ligament injury(2 cases),Hypoechogenicity,hyperosteogeny(75 cases),and sesamoid(50cases).3? The correlation coefficient between ultrasound rating(grade 0~ 4)and VAS score was 0.814 and WOMAC score was 0.899,which was statistically significant(P < 0.01).The correlation coefficient between Magnetic Resonance Imaging rating(grade 0 ~ 4)and VAS score was 0.832 and WOMAC score was 0.897,which was statistically significant(P < 0.01).The correlation coefficient between X-ray rating(grade 0 ~ 4)and VAS score was 0.708 and WOMAC score was 0.734,which was statistically significant(P < 0.01).The correlation coefficient between ultrasound rating and X-ray rating was 0.857,which was statistically significant(P <0.01).The correlation coefficient between ultrasound rating and Magnetic Resonance Imaging rating was 0.043,which was no statistically significant(P > 0.05).The severity of osteoarthritis assessed by ultrasound was higher than that assessed by X-ray in patients with mild lesions(grade 0 ~ 2).Conclusions: 1.Ultrasound and MRI have similar effects in the early diagnosis of knee osteoarthritis,and ultrasound is the preferred examination for patients with knee osteoarthritis due to its non-invasive,cheap,flexible operation and dynamic observation.2.The sensitivity of ultrasound to early knee osteoarthritis was higher than DR.