title: Comparison of Diagnostic Performance of Semi-Quantitative Knee Ultrasound and Knee Radiography with MRI: Oulu Knee Osteoarthritis Study.
abstract: Osteoarthritis (OA) is a common degenerative musculoskeletal disease highly prevalent in aging societies worldwide. Traditionally, knee OA is diagnosed using conventional radiography. However, structural changes of articular cartilage or menisci cannot be directly evaluated using this method. On the other hand, ultrasound is a promising tool able to provide direct information on soft tissue degeneration. The aim of our study was to systematically determine the site-specific diagnostic performance of semi-quantitative ultrasound grading of knee femoral articular cartilage, osteophytes and meniscal extrusion, and of radiographic assessment of joint space narrowing and osteophytes, using MRI as a reference standard. Eighty asymptomatic and 79 symptomatic subjects with mean age of 57.7 years were included in the study. Ultrasound performed best in the assessment of femoral medial and lateral osteophytes, and medial meniscal extrusion. In comparison to radiography, ultrasound performed better or at least equally well in identification of tibio-femoral osteophytes, medial meniscal extrusion and medial femoral cartilage morphological degeneration. Ultrasound provides relevant additional diagnostic information on tissue-specific morphological changes not depicted by conventional radiography. Consequently, the use of ultrasound as a complementary imaging tool along with radiography may enable more accurate and cost-effective diagnostics of knee osteoarthritis at the primary healthcare level.
authors.affiliation: Research Unit of Medical Imaging, Physics and Technology, Infotech Oulu, University of Oulu, Oulu, Finland.
authors.forename: Jana
authors.initials: J
authors.lastname: Podlipská
authors.affiliation: Department of Radiology, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Guermazi
authors.affiliation: Departments of Anatomy and Surgery Clinic, Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.
authors.forename: Petri
authors.initials: P
authors.lastname: Lehenkari
authors.affiliation: Research Unit of Medical Imaging, Physics and Technology, Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.|Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
authors.forename: Jaakko
authors.initials: J
authors.lastname: Niinimäki
authors.affiliation: Department of Radiology, Boston University School of Medicine, Boston, MA, USA.|Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Frank W
authors.initials: FW
authors.lastname: Roemer
authors.affiliation: Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.|Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Jari P
authors.initials: JP
authors.lastname: Arokoski
authors.affiliation: Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.|Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Päivi
authors.initials: P
authors.lastname: Kaukinen
authors.affiliation: Research Unit of Medical Imaging, Physics and Technology, Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.|Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
authors.forename: Esa
authors.initials: E
authors.lastname: Liukkonen
authors.affiliation: Research Unit of Medical Imaging, Physics and Technology, Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.|Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
authors.forename: Eveliina
authors.initials: E
authors.lastname: Lammentausta
authors.affiliation: Research Unit of Medical Imaging, Physics and Technology, Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.|Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
authors.forename: Miika T
authors.initials: MT
authors.lastname: Nieminen
authors.affiliation: Research Unit of Medical Imaging, Physics and Technology, Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.|Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
authors.forename: Osmo
authors.initials: O
authors.lastname: Tervonen
authors.affiliation: Department of Internal Medicine, Mikkeli Central Hospital, Mikkeli, Finland.
authors.forename: Juhani M
authors.initials: JM
authors.lastname: Koski
authors.affiliation: Research Unit of Medical Imaging, Physics and Technology, Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.|Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
authors.forename: Simo
authors.initials: S
authors.lastname: Saarakkala
mesh_terms: D002358:Cartilage, Articular / Q000473:pathology / Q000648:ultrastructure*; D005260:Female; D006801:Humans; D007717:Knee / Q000473:pathology; D007719:Knee Joint / Q000473:pathology / Q000648:ultrastructure*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology / Q000648:ultrastructure*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014463:Ultrasonography / Q000379:methods*