Ultrasound assessment of osteoarthritis: Current status

Ultrasound (US) is an accessible and inexpensive imaging modality providing an enticing tool to assess both the structural and inflammatory changes in osteoarthritic joints.

Traditionally, osteoarthritis (OA) is diagnosed with the clinical examination supplemented by the conventional radiography (CR). In the research literature, the role of ultrasound (US) imaging in the diagnostics of OA has risen steadily during the last two decades. US imaging is cheap and globally widely available often already in primary healthcare.

Mika T. Nevalainen et al reviewed the most essential US literature focusing on OA diagnostics and progression prediction using the various search engines (PubMed, MEDLINE -via OVID and The Cochrane Central Register of Controlled Trials). The search provided 1445 journal articles. After reviewing the abstracts, 89 articles were finally included in the study. The review article has been published in ‘Skeletal Radiology’.

• US imaging is cheap and globally widely available already in several primary healthcare facilities.

• Most of the reviewed articles focused on the imaging of knee and hand OA, whereas only a minority dealt with the imaging of hip, ankle, midfoot, acromioclavicular, and temporomandibular joints.

• Although the overall association between the imaging findings and pain or symptoms related to knee OA is traditionally known to be rather poor, the recent US literature suggests otherwise.

• The overall reliability of the US to assess knee OA has been found good to excellent.

• The major drawback of the US assessment of joints is the lack of visualization within the intra-articular structures.

The authors concluded that - “In knee and hand joints, US imaging has been reported to be a promising tool to evaluate OA changes. Furthermore, the reproducibility of US as well as its association to MRI findings is excellent. Importantly, US seem to even outperform CR in certain aspects, such as detection of osteophytes, joint inflammation, meniscus protrusion, and localized cartilage damage (especially at the medial femoral condyle and sulcus area). Based on the reviewed literature, US can be truly considered as a complementary tool to CR in the clinical setup for OA diagnostics. New technical developments may even enhance the diagnostic value of the US in the future.”

Further reading:

The ultrasound assessment of osteoarthritis: the current status

Mika T. Nevalainen et al

Skeletal Radiology (2023) 52:2271–2282

https://doi.org/10.1007/s00256-023-04342-3