Abstract
Purpose
MRI is now the modality of choice for evaluating articular cartilage. Nevertheless, it has some general drawbacks. Some patients cannot undergo MRI, and in others US scan could be the first examination and cartilage should be evaluated. Ultrasound could be a useful method for detecting trochlear cartilage low-grade lesions. In this study, our goal was to evaluate the efficacy of ultrasonography in detecting these lesions.
Methods
All patients referred to our hospital, from July 2018 to July 2019, who were arthroscopic candidates due to sport-related pathologies, underwent ultrasound scan 1 day prior to surgery. Ultrasound assessment was performed by an expert radiologist, with a 13-MHz probe, located transversely proximal to the patella in different degrees of knee flexion to assess trochlear lesion grade and thickness. Arthroscopic examination of all patients was performed by an experienced orthopedic knee surgeon (second author). Sensitivity and specificity of ultrasound were calculated.
Results
A total of 48 patients were involved in the study with a mean age of 33.2 years (SD: 9.7), between 19 and 51 years of age. Patients were 81% male (39 patients). The sensitivity of ultrasound in grading of trochlear cartilage lesion was 100%, meanwhile its specificity was 88.2% (30 cases had normal cartilage while this figure was 34 in arthroscopy).
Conclusion
Sonography is a low-cost, accessible diagnostic tool with high sensitivity and specificity for early detection of trochlear cartilage pathologies. It can play an important role as an outpatient diagnostic workup in patients with anterior knee pain.
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References
Aisen AM et al (1984) Sonographic evaluation of the cartilage of the knee. Radiology 153(3):781–784
Robotti G et al (2020) Ultrasound of sports injuries of the musculoskeletal system: gender differences. J Ultrasound. https://doi.org/10.1007/s40477-020-00438-x
Draghi F et al (2019) Non-rotator cuff calcific tendinopathy: ultrasonographic diagnosis and treatment. J Ultrasound. https://doi.org/10.1007/s40477-019-00393-2
Draghi F et al (2008) Overload syndromes of the knee in adolescents: sonographic findings. J Ultrasound 11(4):151–157
Zytoon AA et al (2014) Ultrasound assessment of elbow enthesitis in patients with seronegative arthropathies. J Ultrasound 17(1):33–40
Muhle C et al (2008) Magnetic resonance imaging of the femoral trochlea: evaluation of anatomical landmarks and grading articular cartilage in cadaveric knees. Skelet Radiol 37(6):527–533
Lee MJ, Chow K (2007) Ultrasound of the knee. Semin Musculoskelet Radiol 11(02):137–148
Friedman L, Finlay K, Jurriaans E (2001) Ultrasound of the knee. Skelet Radiol 30(7):361–377
Samim M et al (2014) MRI of anterior knee pain. Skelet Radiol 43(7):875–893
Pellaumail B et al (2002) Effect of articular cartilage proteoglycan depletion on high frequency ultrasound backscatter. Osteoarthr Cartil 10(7):535–541
Saarakkala S et al (2004) Ultrasonic quantitation of superficial degradation of articular cartilage. Ultrasound Med Biol 30(6):783–792
Nieminen HJ et al (2002) Real-time ultrasound analysis of articular cartilage degradation in vitro. Ultrasound Med Biol 28(4):519–525
Disler DG et al (2000) Articular cartilage defects: in vitro evaluation of accuracy and interobserver reliability for detection and grading with US. Radiology 215(3):846–851
Kuroki H et al (2008) Ultrasound properties of articular cartilage in the tibio-femoral joint in knee osteoarthritis: relation to clinical assessment (International Cartilage Repair Society grade). Arthr Res Therapy 10(4):R78
Mathiesen O et al (2004) Ultrasonography and articular cartilage defects in the knee: an in vitro evaluation of the accuracy of cartilage thickness and defect size assessment. Knee Surg Sports Traumatol Arthrosc 12(5):440–443
Möller I et al (2008) Ultrasound in the study and monitoring of osteoarthritis. Osteoarthr Cartil 16:S4–S7
Grassi W et al (1999) Sonographic imaging of normal and osteoarthritic cartilage. Semin Arthr Rheum 28(6):398–403
Kazam JK et al (2011) Sonographic evaluation of femoral trochlear cartilage in patients with knee pain. J Ultrasound Med 30(6):797–802
Cao J et al (2018) A novel ultrasound scanning approach for evaluating femoral cartilage defects of the knee: comparison with routine magnetic resonance imaging. J Orthop Surg Res 13(1):178
Mainil-Varlet P et al (2010) A new histology scoring system for the assessment of the quality of human cartilage repair: ICRS II. Am J Sports Med 38(5):880–890
McCune WJ et al (1990) Sonographic evaluation of osteoarthritic femoral condylar cartilage. Correlation with operative findings. Clin Orthop Relat Res 254:230–235
Yoon C-H et al (2008) Validity of the sonographic longitudinal sagittal image for assessment of the cartilage thickness in the knee osteoarthritis. Clin Rheumatol 27(12):1507
(2013) World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 310(20):2191–2194
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the latest Helsinki Declaration in 2013 [23].
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This study was confirmed by the national ethical review committee. This study was performed in Tehran (Iran).
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Aghaghazvini, L., Tahmasebi, M.N., Gerami, R. et al. Sonography: a sensitive and specific method for detecting trochlear cartilage pathologies. J Ultrasound 23, 259–263 (2020). https://doi.org/10.1007/s40477-020-00488-1
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DOI: https://doi.org/10.1007/s40477-020-00488-1