AB0084\u2005ASSOCIATION OF SYNOVITIS VERSUS CARTILAGE LOSS WITH PAIN SEVERITY AND FUNCTIONAL LIMITATION IN PRIMARY KNEE OSTEOARTHRITIS: CLINICAL, ULTRASONOGRAPHY AND MAGNETIC RESONANCE IMAGING

Abstract

Background Osteoarthritis (OA) is a common and debilitating condition associated with pain and the loss of mobility that undermines quality-of-life. Magnetic resonance imaging (MRI) has become the most important modality for assessment of pathologic changes in knee cartilage, in both clinical and research environment, also Musculoskeletal Ultrasound (MSU) is a valuable tool for imaging musculoskeletal changes in osteoarthritis. It shows early and late changes. Objectives The aim of the study was to detect the association of MRI and musculoskeletal ultrasound detected synovitis versus cartilage defect with knee pain severity and functional limitation in patient with primary knee osteoarthritis Methods This study was carried out on fifty patients of primary osteoarthritis diagnosed as primary osteoarthritis of knee joints according to American College of Rheumatology Radiologic and Clinical Criteria for Knee osteoarthritis all patients were assed clinically and knee examined for any swelling tenderness, warmth, limitation of range of motion. Pain severity and functional limitation assessed by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Musculoskeletal ultrasound and M.R.I of osteoarthritic knee joints were done. Results MSUS synovitis of examined joinits was (0.93 ± 0.94) and cartilage thickness(3.95 ± 1.4). MRI synovitis of examined joinits was (0.89 ± 0.93) and cartilage thickness (39.9 ± 13.26), There was Correlation between WOMAC pain score and MSU synovitis and cartilage thickness with Significant difference (p<0.01), also there was Correlation between WOMAC pain score and MRI synovitis and cartilage thickness with Significant difference (p<0.01). a positive Correlation between MSU Synovitis and MSU cartilage thickness was detected Significant difference (p<0.01) r(0.38). Also a Correlation between MRI Synovitis and MRI cartilage thickness show Significant difference (p<0.01) r (0.39). Sagittal an proton density–weighted magnetic resonance imaging shows focal cartilage loss in the lateral tibiofemoral joint Conclusion The severity of cartilage loss and severity of the synovitis/effusion are the most significant determinants of pain and functional disability. Synovitis has role on increasing cartilage los MRI and MSU are a non-invasive method which allows comprehensive assessment and detection of early structural changes in osteoarthritic joints Longitudinal scan show first grade of synovitis of right knee References [1] Gold GE, Chen CA, Koo S, et al. (2009): Recent advances in MRI of articular cartilage. AJR Am J Roentgenol 2009; 193(3):628–638. [2] Iagnocco A (2010): Imaging the joint in osteoarthritis: a place for ultrasound? Best Practice & Research Clinical Rheumatology 2010, 24:27-38. [3] Procházková M, Zanvit P, Dolezal T, et al. (2009): Increased gene expression and production of spinal cyclooxygenase 1 and 2 during experimental osteoarthritis pain. Physiol Res 2009;58:419Y25 Disclosure of Interests None declared