KIVIMA.KI J, RIIHIMAKI H, HA.NNINEN K. Knee disorders in carpet and floor layers and painters. Scand J Work Environ Health 1992;18:310-6. In an evaluation of the effect of kneeling work on the knees, 168 actively working carpet and floor layers and 146 house painters were examined with the aid of a questionnaire, a clinical examination, and radiography. Reported knee pain, knee accidents, and treatment regimens for the knees were more common among the carpet and floor layers than among the painters. Radiographic changes of the tibiofemoral joint were noted equally in the two occupational groups, but osteophytes of the patella were more common among the carpet and floor layers than among the painters. In a multivariate analysis, the determinants of osteophytosis of the knee were age, occupation, knee accidents, and smoking , and osteophytosis may be due to more frequent workbreaks from kneeling postures among smoking workers. This study indicates that kneeling work increases the risk of knee disorders and such radiographic changes that might be an initial sign of knee degeneration.

Paraplegic and tetraplegic subjects are prone to glenohumeral changes that can be verified with ultrasonography.

KIVIMAKI J. Occupationally related ultrasoni c findings in carpet and floor layers' knees. Scand J Work En viron Health 1992;18:400-2. Soft-t issue changes in the anterior aspect of the knees were evaluated with ultrasonography among 96 randomly selected carpet and floor layers and 72 painters . The ultrasonography showed thickening of the prepatellar or superficial infrapatellar bursa in 49070 of the carpet and floor layers and 7% ofthe house painters. Fluid collection in the prepatellar or superficial infrapatellar bursa was noted for 10 car pet and floor layers, and this ultrasonographic finding was associated with knee pain in kneeling postures.

In order to reveal abnormalities in the soft tissue of the anterior part of the knee, caused by protracted mechanical stress, we performed ultrasound studies of both knees of 95 male workers in the carpet-laying and parquet floor trade (group 1). Seventy-three painters (group 2) served as controls. In group I , an anechoic fluid collection was detected in 10 knees, localized in the superficial infrapatellar bursa and in one patient in the prepatellar bursa, whereas there were no cases of fluid accumulation in the controls. A hypoechoic, oval subcutaneous thickening in the anterior wall of the superficial infrapatellar bursa was detected in 35 (18.4%) and 4 (2.7%) knees, respectively. Prepatellar subcutaneous thickening was detected in 45 knees (23.7%) in group 1, but in only 2 knees (1.4%) in group 2. Two knees in group 1 had thickened and inhomogeneous patellar tendons, while one in group 2 had a thickened and 2 both thickened and hypoechoic patellar tendons. We conclude that uitrdsonography is a useful method for the detection of bursitis and soft tissue changes in carpet-layers. Detection of a fluid collection in a bursa does not necessarily denote bursitis of clinical importance, but does signify irritation due to work stress. Patellar tendon pathology is rare among carpet-layers and is probably unrelated to the occupation.

In order to reveal abnormalities in the soft tissue of the anterior part of the knee, caused by protracted mechanical stress, we performed ultrasound studies of both knees of 95 male workers in the carpet-laying and parquet floor trade (group I). Seventy-three painters (group 2) served as controls. In group I, an anechoic fluid collection was detected in 10 knees, localized in the superficial infrapatellar bursa and in one patient in the prepatellar bursa, whereas there were no cases of fluid accumulation in the controls. A hypoechoic, oval subcutaneous thickening in the anterior wall of the superficial infrapatellar bursa was detected in 35 (18.4'/0) and 4 (2.7%) knees, respectively. Prepatellar subcutaneous thickening was detected in 45 knees (23.7%) in group I, but in only 2 knees (1.4%) in group 2. Two knees in group I had thickened and inhomogeneous patellar tendons, while one in group 2 had a thickened and 2 both thickened and hypoechoic patellar tendons. We conclude that ultrasonography is a useful method for the detection of bursitis and soft tissue changes in carpet-layers. Detection of a fluid collection in a bursa does not necessarily denote bursitis of clinical importance, but does signify irritation due to work stress. Patellar tendon pathology is rare among carpet-layers and is probably unrelated to the occupation.