Ultrasonography findings in knee osteoarthritis: a prospective observational cross-sectional study of 100 Patients

Introduction: Worldwide, knee osteoarthritis (KOA) accounts for 2.2% of total years lived with disability. There is low correlation between joint tissue damage and pain intensity. Periarticular structures may be involved and cannot be identified in X-rays. Objectives: To describe the main ultrasonography (USG) changes in symptomatic patients with primary KOA; to correlate number of USG findings with KOA severity assessed by Kellgren and Lawrence (K&L) radiological scores, with pain intensity measured by a visual analogue scale (VAS) and with functioning scores assessed with Timed up and go test (TUG) and Western Ontario and McMaster Universities (WOMAC) questionnaire. Methods: 100 patients with primary symptomatic KOA were assessed with X-ray and USG. Quantitative and qualitative analyses were evaluated in a systematic manner. Results: The most frequent findings were joint effusion, pes anserinus bursitis, quadriceps tendon enthesopathy, popliteal cyst, iliotibial band tendinitis and patellar tendinitis. Pearson’s correlation analysis demonstrated a significant moderate positive association between VAS scores and number of USG findings (r=0.36; p<0.0001). The number of USG findings was different between K&L grades I and III (p=0.041), I and IV (p<0.001), and II and IV (p=0.001, ANOVA with Bonferroni correction). There was significant association between number of USG findings and TUG (r=0.18; p=0.014) and WOMAC scores for pain (r=0.16; p<0.029) and physical function domains (r=0.16; p<0.028). Conclusion: The most frequent USG finding was joint effusion. Periarticular structures should be explored as potential sources of pain and disability

Ultrasound features of carpal tunnel syndrome: a prospective case-control study

Purpose The purpose of the study was to examine the most adequate cut-off point for median nerve cross-sectional area and additional ultrasound features supporting the diagnosis of carpal tunnel syndrome (CTS). Material and methods Forty wrists from 31 CTS patients and 63 wrists from 37 asymptomatic volunteers were evaluated by ultrasound. All patients were women. The mean age was 49.1 years (range: 29-78) in the symptomatic and 45.1 years (range 24-82) in the asymptomatic group. Median nerve cross-sectional area was obtained using direct (DT) and indirect (IT) techniques. Median nerve echogenicity, mobility, flexor retinaculum measurement and the anteroposterior (AP) carpal tunnel distance were assessed. This study was IRB-approved and all patients gave informed consent prior to examination. Results In CTS the median nerve cross-sectional area was increased compared with the control group. Median nerve cross-sectional area of 10 mm(2) (DT) and 9 mm(2) (IT) had high sensitivity (85% and 88.5%, respectively), specificity (92.1% and 82.5%) and accuracy (89.3% and 82.5%) in the diagnosis of CTS. CTS patients had an increased carpal tunnel AP diameter, flexor retinaculum thickening, reduced median nerve mobility and decreased median nerve echogenicity. Conclusion Ultrasound assists in the diagnosis of CTS using the median nerve diameter cut-off point of 10 mm(2) (DT) and 9 mm(2) (IT) and several additional findings

Ultrasound evaluation of patients with carpal tunnel syndrome before and after endoscopic release of the transverse carpal ligament

Made available in DSpace on 2019-09-12T16:53:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2007AIM: To evaluate the cross-sectional. area of the median nerve using ultrasound in carpal tunnel syndrome patients before and after endoscopic intervention. MATERIAL AND METHODS: Twenty patients with carpal tunnel syndrome (15 women and five men; mean age 55 years) were prospectively evaluated. Informed consent was obtained from all. participants. The study was approved by our Institutional Review Board (IRB). Median nerve cross-sectional area was evaluated at the proximal level before and at 4, 8, and 12 weeks after endoscopic release of the transverse ligament. In the present study, the median nerve cross-sectional area cut-off point was 10 mm(2). Repeated measures analysis of variance test (ANOVA) was applied to compare the reproducibility of ultrasound measurements before and after intervention. RESULTS: The mean cross-sectional. area of the median nerve was 15 mm(2) (SD +/- 2.1) before surgery; and 11.1 mm(2) (SD +/- 3); 9.2 mm(2) (SD +/- 2); and 8.6 mm(2) (SD +/- 1.6) at 4, 8, and 12 weeks after surgery. Repeated measures analyses of variance were found to be statistically significant (p < 0.001). CONCLUSION: The results of the present study demonstrated that there was a decrease in the cross-sectional. area of the median nerve after the release of the transverse carpal ligament. (c) 2007 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.Univ Sao Paulo, Dept Radiol, BR-05403001 Sao Paulo, Brazil; Universidade de Taubaté (Unitau), Dept Orthoped Surg, Sao Paulo, Brazil; Univ Nebraska, Med Ctr, Dept Radiol, Lincoln, NE 68583 USA; Hop La Pitie Salpetriere, Dept Radiol, Paris, France; Clin Lilas, Paris, Franc