| BackgroundKnee osteoarthritis is a chronic joint disease with nonspecific inflammation with degeneration of articular cartilage,women are prone to illness,it is characterized by hyperosteogeny and degeneration,joint ulcers,cracks and fibrosis.Long-term bone cartilage damage can cause joint malformations,and severe results in loss of function or disability if treatment is not given in time.Therefore,the early detection and treatment of knee osteoarthritis has important clinical significance.There are many clinical examination methods,but because of the particularity of the disease,this results in little clinical value in the examination of joint cartilage,synovial thickening,meniscus,tendon ligament,articular effusion and popliteal cyst,muscle bone ultrasound and MRI have important application value in knee osteoarthritis,and muscle bone ultrasound has the advantages of real-time dynamic,easy to repeat and convenient examination,high sensitivity,less restrictions,cheap and so on,which is easy to be accepted by patients,it can provide clinical development and therapeutic effect at any time.ObjectiveBy comparing the results of muscle-bone ultrasound and MRI,this paper discusses the ability of muscle-bone ultrasound to display knee joint lesions,summarizes its sonographic characteristics,and explores the clinical value of muscle-bone ultrasound and MRI in the diagnosis and treatment of knee osteoarthritis,so as to provide more imaging basis for the diagnosis and treatment of knee osteoarthritis.MethodsThe data of 120 cases of knee osteoarthritis confirmed by muscle bone ultrasound and magnetic resonance imaging were analyzed retrospectively,based on arthroscopy,including 42 males and 78 females,aged 40 to 65 years,to be a case group,muscle bone ultrasound,magnetic resonance imaging and arthroscopy were performed;there were 40 normal groups,80 knee joints,12 males and 28 females,the age range was 20 to 38 years,muscle bone ultrasound and magnetic resonance examination.The thickness of articular cartilage was measured by muscle bone ultrasound and magnetic resonance imaging in normal group and case group,including femoral trochlear,the anterior,load-bearing area,and rear of the medial and lateral condyles of the femurs.Both tests can accurately assess the thickness of articular cartilage.The case group was examined by imaging,observation of articular cartilage injury,synovium thickening,meniscal injury,ligament injury,socket cyst and joint cavity effusion,the imaging features were summarized and the coincidence rate was calculated.The statistical data of SPSS17.0 statistical software and the counting data were compared with the other two methods,the counting data were compared with χ2test,the difference was statistically significant(P < 0.05).Calculation: The diagnostic coincidence rate was ultrasound or MRI / arthroscopy × 100%.Results1.The thickness of each part of the knee joint was different in the normal group,the thickness of femoral trochlear measured by muscle bone ultrasound was 2.41 ±0.37 mm,The anterior,bearing and posterior of the lateral femoral condyle were 1.31 ±0.41 mm,1.42 ±0.16 mm,1.45 ±0.13 mm,the front side of the medial condyle of the femur,the bearing area,and the posterior side were 1.22 ±0.11 mm,1.31 ±0.16 mm,1.34 ±0.17 mm;the thickness of femoral trochlear measured by MRI were 2.71 ±0.41 mm,The anterior,bearing and posterior of the lateral femoral condyle were 1.63 ±0.23 mm,1.81±0.29 mm,1.79 ±0.20 mm,the front side of the medial condyle of the femur,the bearing area,and the posterior side were 1.56 ±0.18 mm,1.72 ±0.25 mm,1.73 ±0.15 mm.There was significant difference in the thickness of the medial condyle,the load-bearing area,the posterior condyle and the lateral condyle between the anterior condyle,the load-bearing area and the lateral condyle(P < 0.05).2.Knee osteoarthritis group,The thickness of each part of the knee joint was different in the normal group,the thickness of femoral trochlear measured by muscle bone ultrasound were 1.94 ±0.28 mm,The anterior,bearing and posterior of the lateral femoral condyle were 1.02 ±0.20 mm,0.88 ±0.27 mm,0.99 ±0.20 mm,the front side of the medial condyle of the femur,the bearing area,and the posterior side were 0.98 ±0.18 mm,0.81 ±0.27 mm,0.95 ±0.21 mm;the thickness of femoral trochlear measured by MRI was 1.71 ±0.71 mm,The anterior,bearing and posterior of the lateral femoral condyle were 1.39 ±0.71 mm,0.98±0.71 mm,1.25±0.80 mm,the front side of the medial condyle of the femur,the bearing area,and the posterior side were 1.20 ±0.80 mm,0.77 ±0.65 mm,1.06 ±0.67 mm.The thickness of articular cartilage in all the above sites was significantly thinned,and the difference was significant compared with the normal knee cartilage thickness(P < 0.05).3.The coincidence rate and total coincidence rate of muscle-bone ultrasound on the level of I-IV in articular cartilage 52.4%,61.4%,87.3%,91.7%,82.8%,respectively.MRI was 61.9%,71.9%,90.7%,94.7%,87.5%,respectively.There was no significant difference in the coincidence rate and total coincidence between the two groups(P > 0.05).4.The muscle-bone ultrasound is more convenient and sensitive to the diagnosis of early synovitis,the coincidence rate(96.30%)was higher than that of the MRI(94.78%).The coincidence rate of the two methods for the diagnosis of the internal lateral collateral ligament injury,the joint cavity effusion and the diagnosis of the fossa cyst is higher,the ultrasonic coincidence rate of the muscle and bone was 93.33%,92.17% and 100%,respectively,the coincidence rate of MRI was 100%,94.78% and 100%,respectively.The coincidence rate(66.36%,43.33%)in the diagnosis of the injury of the meniscus and the anterior and posterior cruciate ligament was significantly lower than that of the MRI(100%,73.33%).ConclusionMuscle bone ultrasound diagnosis of early synovial lesions in knee osteoarthritis,the coincidence rate with arthroscopic diagnosis results is higher,there is no statistical difference between the diagnosis of articular cartilage injury and MRI,muscle bone ultrasound provides more imaging basis for the diagnosis of knee osteoarthritis,which has a certain clinical application value. |
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