Atlas-based knee osteophyte assessment with ultrasonography and radiography: relationship to arthroscopic degeneration of articular cartilage.
OBJECTIVE
To investigate intra- and inter-reader agreement of ultrasonography (US) and conventional radiography (CR) for the evaluation of osteophyte presence and size within the tibiofemoral joint. In addition, to correlate these findings with arthroscopic degeneration of the articular cartilage.


METHODS
Forty adult patients with knee pain were enrolled in this study. Knee CR and US scanning of the medial and lateral bone margins were performed on all patients. A novel atlas for the US grading of knee osteophytes was used in the evaluation. The number and size of the osteophytes were evaluated semi-quantitatively in two rounds from both the CR images (four readers) and the US images (14 readers). The Noyes grading system was used for the evaluation of arthroscopic degeneration of the articular cartilage in 26 patients.


RESULTS
On average, intra- and inter-reader US and CR agreement was substantial and comparable to each other (κ = 0.60-0.72). US detected more osteophytes than CR at both the medial (65% vs. 48%) and lateral (70% vs. 60%) compartments. A statistically significant correlation between CR- or US-based osteophyte and arthroscopy grades was observed only for US at the medial compartment (rs = 0.747, p < 0.001).


CONCLUSIONS
The detection of knee osteophytes using the novel US atlas is as reproducible as reading conventional radiographs. US is more sensitive to detect knee osteophytes than CR. Furthermore, osteophytes detected with US correlate significantly with arthroscopic cartilage changes at the medial knee compartment whereas those detected by CR do not.
a Department of Internal Medicine , Mikkeli Central Hospital , Finland.
J M
JM
Koski
b Department of Diagnostic Radiology , Oulu University Hospital , Finland.
A
A
Kamel
c Department of Surgery , Mikkeli Central Hospital , Finland.
P
P
Waris
c Department of Surgery , Mikkeli Central Hospital , Finland.
V
V
Waris
c Department of Surgery , Mikkeli Central Hospital , Finland.
I
I
Tarkiainen
c Department of Surgery , Mikkeli Central Hospital , Finland.
E
E
Karvanen
d Department of Rheumatology , Copenhagen University Hospital at Køge , Denmark.
M
M
Szkudlarek
e Istanbul Medeniyet University, Goztepe Training and Research Hospital , Istanbul , Turkey.
S Z
SZ
Aydin
f Division of Rheumatology, Department of Internal Medicine , Oulu University Hospital , Finland.
E
E
Alasaarela
g Immanuel Krankenhaus, Medical Centre for Rheumatology , Berlin , Germany.
W
W
Schmidt
h la Paz University Hospital , Madrid , Spain.
E
E
De Miguel
i Division of Rheumatology, 3rd Department of Internal Medicine , University of Vienna , Austria.
P
P
Mandl
j Department of Rheumatology , Marche Polytechnic University , Ancona , Italy.
E
E
Filippucci
k Department of Rheumatology and Clinical Immunology/Allergy , Inselspital University Hospital , Bern , Switzerland.
H
H
Ziswiler
l Department of Rheumatology , Copenhagen University Hospital at Glostrup , Denmark.
L
L
Terslev
m National Institute of Rheumatology and Physiotherapy , Budapest , Hungary.
K
K
Áts
m National Institute of Rheumatology and Physiotherapy , Budapest , Hungary.
R
R
Kurucz
n Department of Rheumatology , Gregorio Marañón General University Hospital , Madrid , Spain.
E
E
Naredo
o 3rd Rheumatology Department , National Institute of Rheumatology and Physiotherapy , Budapest , Hungary.
P
P
Balint
p Department of Internal Medicine and Medical Specialties: Rheumatology , Sapienza University of Rome , Italy.
A
A
Iagnocco
b Department of Diagnostic Radiology , Oulu University Hospital , Finland.
S
S
Lepojärvi
b Department of Diagnostic Radiology , Oulu University Hospital , Finland.
A
A
Elseoud
q Department of Radiology , Central Hospital of Central Finland , Jyväskylä , Finland.
M
M
Fouda
b Department of Diagnostic Radiology , Oulu University Hospital , Finland.|r Research Centre for Medical Imaging, Physics and Technology, Faculty of Medicine , University of Oulu , Finland.
S
S
Saarakkala
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy; D001271:Atlases as Topic; D002358:Cartilage, Articular / Q000473:pathology*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D020370:Osteoarthritis, Knee / Q000175:diagnosis* / Q000000981:diagnostic imaging; D054850:Osteophyte / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011859:Radiography; D014463:Ultrasonography