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Published in: Journal of Orthopaedic Surgery and Research 1/2018

Open Access 01-12-2018 | Research article

A novel ultrasound scanning approach for evaluating femoral cartilage defects of the knee: comparison with routine magnetic resonance imaging

Authors: Junyan Cao, Bowen Zheng, Xiaochun Meng, Yan Lv, Huading Lu, Kun Wang, Dongmei Huang, Jie Ren

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2018

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Abstract

Background

This study aimed to assess a novel ultrasound (US) scanning approach in evaluating knee femoral cartilaginous defects, compared with magnetic resonance imaging (MRI, commonly used for knee imaging) and arthroscopy (gold standard).

Methods

Sixty-four consecutive patients (65 knees) were prospectively evaluated between April 2010 and July 2011.

Results

The overall sensitivity (62.2 and 69.4%), specificity (92.9 and 90.5%), accuracy (75.4 and 78.5%), and adjusted positive (88.7 and 90.4%) and negative predictive (69.5 and 73.3%) were similar for both radiologists (weighted κ = 0.76). Furthermore, agreement between grading by US and MRI was substantial (weighted κ = 0.61).

Conclusions

In conclusion, the novel US scanning approach allows similar diagnostic performance compared to routine MRI for knee cartilage defects. US is more accessible, easier to perform, and less expensive than MRI, with potential advantages of easier initial screening and assessment of cartilage defects.
Appendix
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Literature
1.
go back to reference Urwin M, Symmons D, Allison T, Brammah T, Busby H, Roxby M, et al. Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis. 1998;57:649–55.CrossRefPubMedPubMedCentral Urwin M, Symmons D, Allison T, Brammah T, Busby H, Roxby M, et al. Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis. 1998;57:649–55.CrossRefPubMedPubMedCentral
2.
go back to reference Buckwalter JA, Mankin HJ. Articular cartilage repair and transplantation. Arthritis Rheum. 1998;41:1331–42.CrossRefPubMed Buckwalter JA, Mankin HJ. Articular cartilage repair and transplantation. Arthritis Rheum. 1998;41:1331–42.CrossRefPubMed
3.
go back to reference Qvistgaard E, Kristoffersen H, Terslev L, Danneskiold-Samsoe B, Torp-Pedersen S, Bliddal H. Guidance by ultrasound of intra-articular injections in the knee and hip joints. Osteoarthr Cartil. 2001;9:512–7.CrossRefPubMed Qvistgaard E, Kristoffersen H, Terslev L, Danneskiold-Samsoe B, Torp-Pedersen S, Bliddal H. Guidance by ultrasound of intra-articular injections in the knee and hip joints. Osteoarthr Cartil. 2001;9:512–7.CrossRefPubMed
4.
go back to reference Wakefield RJ, Gibbon WW, Emery P. The current status of ultrasonography in rheumatology. Rheumatology (Oxford). 1999;38:195–8.CrossRef Wakefield RJ, Gibbon WW, Emery P. The current status of ultrasonography in rheumatology. Rheumatology (Oxford). 1999;38:195–8.CrossRef
5.
go back to reference McCune WJ, Dedrick DK, Aisen AM, MacGuire A. Sonographic evaluation of osteoarthritic femoral condylar cartilage. Correlation with operative findings. Clin Orthop Relat Res. 1990;254:230–5. McCune WJ, Dedrick DK, Aisen AM, MacGuire A. Sonographic evaluation of osteoarthritic femoral condylar cartilage. Correlation with operative findings. Clin Orthop Relat Res. 1990;254:230–5.
6.
go back to reference Iagnocco A, Coari G, Zoppini A. Sonographic evaluation of femoral condylar cartilage in osteoarthritis and rheumatoid arthritis. Scand J Rheumatol. 1992;21:201–3.CrossRefPubMed Iagnocco A, Coari G, Zoppini A. Sonographic evaluation of femoral condylar cartilage in osteoarthritis and rheumatoid arthritis. Scand J Rheumatol. 1992;21:201–3.CrossRefPubMed
7.
go back to reference Grassi W, Lamanna G, Farina A, Cervini C. Sonographic imaging of normal and osteoarthritic cartilage. Semin Arthritis Rheum. 1999;28:398–403.CrossRefPubMed Grassi W, Lamanna G, Farina A, Cervini C. Sonographic imaging of normal and osteoarthritic cartilage. Semin Arthritis Rheum. 1999;28:398–403.CrossRefPubMed
8.
go back to reference Batalov AZ, Kuzmanova SI, Penev DP. Ultrasonographic evaluation of knee joint cartilage in rheumatoid arthritis patients. Folia Med (Plovdiv). 2000;42:23–6. Batalov AZ, Kuzmanova SI, Penev DP. Ultrasonographic evaluation of knee joint cartilage in rheumatoid arthritis patients. Folia Med (Plovdiv). 2000;42:23–6.
9.
go back to reference Disler DG, Raymond E, May DA, Wayne JS, McCauley TR. Articular cartilage defects: in vitro evaluation of accuracy and interobserver reliability for detection and grading with US. Radiology. 2000;215:846–51.CrossRefPubMed Disler DG, Raymond E, May DA, Wayne JS, McCauley TR. Articular cartilage defects: in vitro evaluation of accuracy and interobserver reliability for detection and grading with US. Radiology. 2000;215:846–51.CrossRefPubMed
10.
go back to reference Mathiesen O, Konradsen L, Torp-Pedersen S, Jorgensen U. 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. 2004;12:440–3.CrossRefPubMed Mathiesen O, Konradsen L, Torp-Pedersen S, Jorgensen U. 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. 2004;12:440–3.CrossRefPubMed
11.
go back to reference Tsai CY, Lee CL, Chai CY, Chen CH, Su JY, Huang HT, et al. The validity of in vitro ultrasonographic grading of osteoarthritic femoral condylar cartilage—a comparison with histologic grading. Osteoarthr Cartil. 2007;15:245–50.CrossRefPubMed Tsai CY, Lee CL, Chai CY, Chen CH, Su JY, Huang HT, et al. The validity of in vitro ultrasonographic grading of osteoarthritic femoral condylar cartilage—a comparison with histologic grading. Osteoarthr Cartil. 2007;15:245–50.CrossRefPubMed
12.
go back to reference Yoon CH, Kim HS, Ju JH, Jee WH, Park SH, Kim HY. Validity of the sonographic longitudinal sagittal image for assessment of the cartilage thickness in the knee osteoarthritis. Clin Rheumatol. 2008;27:1507–16.CrossRefPubMed Yoon CH, Kim HS, Ju JH, Jee WH, Park SH, Kim HY. Validity of the sonographic longitudinal sagittal image for assessment of the cartilage thickness in the knee osteoarthritis. Clin Rheumatol. 2008;27:1507–16.CrossRefPubMed
13.
go back to reference Lee CL, Huang MH, Chai CY, Chen CH, Su JY, Tien YC. The validity of in vivo ultrasonographic grading of osteoarthritic femoral condylar cartilage: a comparison with in vitro ultrasonographic and histologic gradings. Osteoarthr Cartil. 2008;16:352–8.CrossRefPubMed Lee CL, Huang MH, Chai CY, Chen CH, Su JY, Tien YC. The validity of in vivo ultrasonographic grading of osteoarthritic femoral condylar cartilage: a comparison with in vitro ultrasonographic and histologic gradings. Osteoarthr Cartil. 2008;16:352–8.CrossRefPubMed
14.
go back to reference Saarakkala S, Waris P, Waris V, Tarkiainen I, Karvanen E, Aarnio J, et al. Diagnostic performance of knee ultrasonography for detecting degenerative changes of articular cartilage. Osteoarthr Cartil. 2012;20:376–81.CrossRefPubMed Saarakkala S, Waris P, Waris V, Tarkiainen I, Karvanen E, Aarnio J, et al. Diagnostic performance of knee ultrasonography for detecting degenerative changes of articular cartilage. Osteoarthr Cartil. 2012;20:376–81.CrossRefPubMed
15.
go back to reference Shahriaree H. O’Connor’s textbook of arthroscopic surgery. Philadelphia: Lippincott; 1992. Shahriaree H. O’Connor’s textbook of arthroscopic surgery. Philadelphia: Lippincott; 1992.
16.
go back to reference Li Y, Hua Y, Fang J, Wang C, Qiao L, Wan C, et al. Performance of different scan protocols of fetal echocardiography in the diagnosis of fetal congenital heart disease: a systematic review and meta-analysis. PLoS One. 2013;8:e65484.CrossRefPubMedPubMedCentral Li Y, Hua Y, Fang J, Wang C, Qiao L, Wan C, et al. Performance of different scan protocols of fetal echocardiography in the diagnosis of fetal congenital heart disease: a systematic review and meta-analysis. PLoS One. 2013;8:e65484.CrossRefPubMedPubMedCentral
17.
go back to reference Dexheimer Neto FL, Andrade JM, Raupp AC, Townsend Rda S, Beltrami FG, Brisson H, et al. Diagnostic accuracy of the bedside lung ultrasound in emergency protocol for the diagnosis of acute respiratory failure in spontaneously breathing patients. J Bras Pneumol. 2015;41:58–64.CrossRefPubMed Dexheimer Neto FL, Andrade JM, Raupp AC, Townsend Rda S, Beltrami FG, Brisson H, et al. Diagnostic accuracy of the bedside lung ultrasound in emergency protocol for the diagnosis of acute respiratory failure in spontaneously breathing patients. J Bras Pneumol. 2015;41:58–64.CrossRefPubMed
18.
go back to reference Nazerian P, Tozzetti C, Vanni S, Bartolucci M, Gualtieri S, Trausi F, et al. Accuracy of abdominal ultrasound for the diagnosis of pneumoperitoneum in patients with acute abdominal pain: a pilot study. Crit Ultrasound J. 2015;7:15.CrossRefPubMedPubMedCentral Nazerian P, Tozzetti C, Vanni S, Bartolucci M, Gualtieri S, Trausi F, et al. Accuracy of abdominal ultrasound for the diagnosis of pneumoperitoneum in patients with acute abdominal pain: a pilot study. Crit Ultrasound J. 2015;7:15.CrossRefPubMedPubMedCentral
19.
go back to reference Brittberg M, Winalski CS. Evaluation of cartilage injuries and repair. J Bone Joint Surg Am. 2003;85-A(Suppl 2):58–69.CrossRef Brittberg M, Winalski CS. Evaluation of cartilage injuries and repair. J Bone Joint Surg Am. 2003;85-A(Suppl 2):58–69.CrossRef
20.
go back to reference Aisen AM, McCune WJ, MacGuire A, Carson PL, Silver TM, Jafri SZ, et al. Sonographic evaluation of the cartilage of the knee. Radiology. 1984;153:781–4.CrossRefPubMed Aisen AM, McCune WJ, MacGuire A, Carson PL, Silver TM, Jafri SZ, et al. Sonographic evaluation of the cartilage of the knee. Radiology. 1984;153:781–4.CrossRefPubMed
23.
go back to reference Jiang F, Xu B, Zhang XS, Wang L, Wen CJ. Feasibility of the femoral condylar cartilage ultrasound imaging. Acta Univ Med Anhui. 2003;38:144–6. Jiang F, Xu B, Zhang XS, Wang L, Wen CJ. Feasibility of the femoral condylar cartilage ultrasound imaging. Acta Univ Med Anhui. 2003;38:144–6.
24.
25.
go back to reference Goodfellow J, Hungerford DS, Zindel M. Patello-femoral joint mechanics and pathology. 1. Functional anatomy of the patello-femoral joint. J Bone Joint Surg Br. 1976;58:287–90.CrossRefPubMed Goodfellow J, Hungerford DS, Zindel M. Patello-femoral joint mechanics and pathology. 1. Functional anatomy of the patello-femoral joint. J Bone Joint Surg Br. 1976;58:287–90.CrossRefPubMed
26.
go back to reference Roemer FW, Crema MD, Trattnig S, Guermazi A. Advances in imaging of osteoarthritis and cartilage. Radiology. 2011;260:332–54.CrossRefPubMed Roemer FW, Crema MD, Trattnig S, Guermazi A. Advances in imaging of osteoarthritis and cartilage. Radiology. 2011;260:332–54.CrossRefPubMed
27.
go back to reference Ostergaard M, Court-Payen M, Gideon P, Wieslander S, Cortsen M, Lorenzen I, et al. Ultrasonography in arthritis of the knee. A comparison with MR imaging. Acta Radiol. 1995;36:19–26.CrossRefPubMed Ostergaard M, Court-Payen M, Gideon P, Wieslander S, Cortsen M, Lorenzen I, et al. Ultrasonography in arthritis of the knee. A comparison with MR imaging. Acta Radiol. 1995;36:19–26.CrossRefPubMed
28.
go back to reference Tarhan S, Unlu Z. Magnetic resonance imaging and ultrasonographic evaluation of the patients with knee osteoarthritis: a comparative study. Clin Rheumatol. 2003;22:181–8.CrossRefPubMed Tarhan S, Unlu Z. Magnetic resonance imaging and ultrasonographic evaluation of the patients with knee osteoarthritis: a comparative study. Clin Rheumatol. 2003;22:181–8.CrossRefPubMed
30.
go back to reference Kim HK, Babyn PS, Harasiewicz KA, Gahunia HK, Pritzker KP, Foster FS. Imaging of immature articular cartilage using ultrasound backscatter microscopy at 50 MHz. J Orthop Res. 1995;13:963–70.CrossRefPubMed Kim HK, Babyn PS, Harasiewicz KA, Gahunia HK, Pritzker KP, Foster FS. Imaging of immature articular cartilage using ultrasound backscatter microscopy at 50 MHz. J Orthop Res. 1995;13:963–70.CrossRefPubMed
31.
go back to reference Roemer FW, van Holsbeeck M, Genant HK. Musculoskeletal ultrasound in rheumatology: a radiologic perspective. Arthritis Rheum. 2005;53:491–3.CrossRefPubMed Roemer FW, van Holsbeeck M, Genant HK. Musculoskeletal ultrasound in rheumatology: a radiologic perspective. Arthritis Rheum. 2005;53:491–3.CrossRefPubMed
32.
go back to reference Kijowski R, Blankenbaker DG, Davis KW, Shinki K, Kaplan LD, De Smet AA. Comparison of 1.5- and 3.0-T MR imaging for evaluating the articular cartilage of the knee joint. Radiology. 2009;250:839–48.CrossRefPubMed Kijowski R, Blankenbaker DG, Davis KW, Shinki K, Kaplan LD, De Smet AA. Comparison of 1.5- and 3.0-T MR imaging for evaluating the articular cartilage of the knee joint. Radiology. 2009;250:839–48.CrossRefPubMed
33.
go back to reference Kijowski R, Blankenbaker DG, Woods MA, Shinki K, De Smet AA, Reeder SB. 3.0-T evaluation of knee cartilage by using three-dimensional IDEAL GRASS imaging: comparison with fast spin-echo imaging. Radiology. 2010;255:117–27.CrossRefPubMed Kijowski R, Blankenbaker DG, Woods MA, Shinki K, De Smet AA, Reeder SB. 3.0-T evaluation of knee cartilage by using three-dimensional IDEAL GRASS imaging: comparison with fast spin-echo imaging. Radiology. 2010;255:117–27.CrossRefPubMed
34.
go back to reference Duc SR, Pfirrmann CW, Schmid MR, Zanetti M, Koch PP, Kalberer F, et al. Articular cartilage defects detected with 3D water-excitation true FISP: prospective comparison with sequences commonly used for knee imaging. Radiology. 2007;245:216–23.CrossRefPubMed Duc SR, Pfirrmann CW, Schmid MR, Zanetti M, Koch PP, Kalberer F, et al. Articular cartilage defects detected with 3D water-excitation true FISP: prospective comparison with sequences commonly used for knee imaging. Radiology. 2007;245:216–23.CrossRefPubMed
35.
go back to reference Disler DG, McCauley TR, Wirth CR, Fuchs MD. Detection of knee hyaline cartilage defects using fat-suppressed three-dimensional spoiled gradient-echo MR imaging: comparison with standard MR imaging and correlation with arthroscopy. AJR Am J Roentgenol. 1995;165:377–82.CrossRefPubMed Disler DG, McCauley TR, Wirth CR, Fuchs MD. Detection of knee hyaline cartilage defects using fat-suppressed three-dimensional spoiled gradient-echo MR imaging: comparison with standard MR imaging and correlation with arthroscopy. AJR Am J Roentgenol. 1995;165:377–82.CrossRefPubMed
36.
go back to reference Eckstein F, Hudelmaier M, Wirth W, Kiefer B, Jackson R, Yu J, et al. Double echo steady state magnetic resonance imaging of knee articular cartilage at 3 Tesla: a pilot study for the osteoarthritis initiative. Ann Rheum Dis. 2006;65:433–41.CrossRefPubMed Eckstein F, Hudelmaier M, Wirth W, Kiefer B, Jackson R, Yu J, et al. Double echo steady state magnetic resonance imaging of knee articular cartilage at 3 Tesla: a pilot study for the osteoarthritis initiative. Ann Rheum Dis. 2006;65:433–41.CrossRefPubMed
37.
go back to reference Duc SR, Koch P, Schmid MR, Horger W, Hodler J, Pfirrmann CW. Diagnosis of articular cartilage abnormalities of the knee: prospective clinical evaluation of a 3D water-excitation true FISP sequence. Radiology. 2007;243:475–82.CrossRefPubMed Duc SR, Koch P, Schmid MR, Horger W, Hodler J, Pfirrmann CW. Diagnosis of articular cartilage abnormalities of the knee: prospective clinical evaluation of a 3D water-excitation true FISP sequence. Radiology. 2007;243:475–82.CrossRefPubMed
38.
go back to reference Kim YJ, Jaramillo D, Millis MB, Gray ML, Burstein D. Assessment of early osteoarthritis in hip dysplasia with delayed gadolinium-enhanced magnetic resonance imaging of cartilage. J Bone Joint Surg Am. 2003;85-A:1987–92.CrossRefPubMed Kim YJ, Jaramillo D, Millis MB, Gray ML, Burstein D. Assessment of early osteoarthritis in hip dysplasia with delayed gadolinium-enhanced magnetic resonance imaging of cartilage. J Bone Joint Surg Am. 2003;85-A:1987–92.CrossRefPubMed
39.
go back to reference Borthakur A, Shapiro EM, Beers J, Kudchodkar S, Kneeland JB, Reddy R. Sensitivity of MRI to proteoglycan depletion in cartilage: comparison of sodium and proton MRI. Osteoarthr Cartil. 2000;8:288–93.CrossRefPubMed Borthakur A, Shapiro EM, Beers J, Kudchodkar S, Kneeland JB, Reddy R. Sensitivity of MRI to proteoglycan depletion in cartilage: comparison of sodium and proton MRI. Osteoarthr Cartil. 2000;8:288–93.CrossRefPubMed
Metadata
Title
A novel ultrasound scanning approach for evaluating femoral cartilage defects of the knee: comparison with routine magnetic resonance imaging
Authors
Junyan Cao
Bowen Zheng
Xiaochun Meng
Yan Lv
Huading Lu
Kun Wang
Dongmei Huang
Jie Ren
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2018
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-018-0887-x

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