Stratifying Minimal Versus Severe Pain in Knee Osteoarthritis Using a Musculoskeletal Ultrasound Protocol.

Abstract

OBJECTIVE:

The aim of this cross-sectional correlational study was to determine the association of pain with morphologic and inflammatory sonographic findings in patients with knee osteoarthritis.

METHODS:

A total of 113 participants with knee osteoarthritis were assessed using visual analog scale pain score and sonography. Ultrasound evaluation included morphologic changes (ie, articular cartilage degeneration, medial and lateral meniscal protrusion, and presence of osteophytes on the joint margins) and inflammatory changes (ie suprapatellar effusion and/or synovitis, Baker cyst, superficial and deep infrapatellar effusion, pes anserine tendinopathy, and Hoffa panniculitis).

RESULTS:

Cluster analysis via Ward's method grouped patients with minimal pain (visual analog scale score, 0-4) and with substantial pain (visual analog scale score, 5-10). Stepwise logistic regression yielded 5 variables that significantly explained the variation in the probability of perceived substantial pain at 10% level of significance: lateral cartilage clarity (LCC; P = .025), medial cartilage clarity (MCC; P = .20), medial cartilage thickness (MCT; P = .041), medial meniscus protrusion (MMP) (P = .029), and osteophytes at medial femoral margin (P = .082), with 63% overall prediction accuracy. When age and sex were added, 4 variables remained significant at a 10% level of significance: LCC, MCC, MCT, and MMP, with 65% overall prediction accuracy. The receiver operating characteristic curve of this model was 0.667.

CONCLUSION:

The study was able to demonstrate that morphologic abnormalities in the ultrasound parameters for LCC, MCC, MCT, and MMP were able to predict significant joint pain in knee osteoarthritis. There were no inflammatory changes that contributed to significant joint pain in this study.

• Authors: Mary Monica Bernardo-Bueno, Consuelo B Gonzalez-Suarez, Andrea Kristina Malvar, Ronald Cua, Daniel Feliciano, Bee Giok Tan-Sales, Svetlana Maris O Aycardo, Millicent Tan-Ong, Robert Chan, Francisco De Los Reyes
• Journal: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine (J Ultrasound Med) Vol. 38 Issue 6 Pg. 1411-1423 (Jun 2019) ISSN: 1550-9613 [Electronic] England
• PMID: 30239017 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: © 2018 by the American Institute of Ultrasound in Medicine.

Topics

• Aged
• Arthralgia (complications, diagnosis, physiopathology)
• Clinical Protocols
• Cluster Analysis
• Cross-Sectional Studies
• Female
• Humans
• Inflammation (complications, diagnostic imaging, physiopathology)
• Knee Joint (diagnostic imaging, physiopathology)
• Male
• Middle Aged
• Osteoarthritis, Knee (complications, physiopathology)
• Philippines
• Reproducibility of Results
• Severity of Illness Index
• Ultrasonography (methods)