Ultrasonographic Evaluation of Osteoarthritis-affected Knee Joints: Comparison with Kellgren-Lawrence Grading and Pain Scores

Abhay Pratap Singh; Sonal Saran; Brij Bhushan Thukral; Ravikant Kaushik

doi:10.4103/JMU.JMU_45_20

Ultrasonographic Evaluation of Osteoarthritis-affected Knee Joints: Comparison with Kellgren-Lawrence Grading and Pain Scores

J Med Ultrasound. 2021 Mar 20;29(1):39-45. doi: 10.4103/JMU.JMU_45_20. eCollection 2021 Jan-Mar.

Authors

Abhay Pratap Singh¹, Sonal Saran², Brij Bhushan Thukral¹, Ravikant Kaushik¹

Affiliations

¹ Department of Radiodiagnosis, Subharti Medical College, Meerut, Uttar Pradesh, India.
² Department of Radiodiagnosis, AIIMS, Rishikesh, Uttarakhand, India.

Abstract

Background: The objective was to compare ultrasonographic findings with clinical and radiographic findings in osteoarthritis (OA)-affected knee joints.

Methods: This prospective study was conducted in Subharti Medical College, Meerut, after getting clearance from the ethical committee. Eighty-five symptomatic knees fulfilling American College of Rheumatology criteria for OA were included in the study. Patients with trauma, inflammatory, and infective conditions of the knee and with a history of intra-articular interventions and surgery were excluded. Demographic data, body mass index (BMI), visual analog scale (VAS), and Western Ontario and McMaster Universities Arthritis (WOMAC) questionnaire score were obtained. Kellgren-Lawrence (K-L) score was obtained on radiography. Ultrasonographic findings which were recorded include effusion, meniscal extrusion, femorotrochlear cartilage grading, maximum length of osteophytes at medial and lateral compartments, and presence or absence of Baker cyst.

Results: A total of 85 consecutive symptomatic knees were examined. The male: female ratio was 22:63, with a mean age of 54.52 ± 9.44 years, mean duration of disease of 24.24 ± 19.14 months, mean BMI of 28.91 ± 3.69 kg/m², and mean score of VAS and WOMAC pain scale of 6.27 ± 1.45 and 62.45 ± 10.96, respectively. K-L grading of 1, 2, 3, and 4 was reported in 12.9%, 21.2%, 25.9%, and 40% of the knees, respectively. The mean VAS score and WOMAC score showed statistically significant correlation with KL grading (P < 0.05). Knees with the presence of osteophytes, medial meniscal extrusion, effusion, and medial femoral trochlear cartilage grading showed statistically significant correlation with VAS and WOMAC scores (P < 0.05). However, the correlation was not significant for lateral meniscus extrusion and lateral femoral trochlear cartilage grading.

Conclusion: Our study found that K-L grading and few ultrasonographic criteria showed a significant positive correlation with pain scores, while few other ultrasonographic criteria did not. Both imaging modalities are complementary to each other, rather than one being superior to the other.

Keywords: Cartilage; Kellgren–Lawrence grading; Western Ontario and McMaster Universities Arthritis Scores; ultrasonography; visual analog scale score.