Correlation of power Doppler sonography with vascularity of the synovial tissue of the knee joint in patients with osteoarthritis and rheumatoid arthritis

Abstract

Objective. To examine the significance of power Doppler sonography (PDS) in the diagnosis of synovial hypertrophy of the knee joint by verifying and comparing the PDS findings with histopathologic findings of synovial membrane vascularity.Methods. The knee joints of 23 patients who were undergoing arthroplasty of the knee joint because of osteoarthritis or rheumatoid arthritis were examined with ultrasound before arthroplasty. The vascularity of the synovial membrane was classified semiquantitatively using PDS. A sample of synovial tissue was obtained during the arthroplasty, and the vascularity of the synovial tissue was evaluated by immunohistochemistry (factor VIII) and was graded qualitatively by a pathologist who was unaware of the PDS findings. The visual qualitative grading by the examiner was controlled by analyzing PDS images and histologic samples using a digital image evaluation system.Results. The correlation between the qualitative PDS results and the qualitative grading of the vascularity by the pathologist was 0.89 by Spearman's (P < 0.01). The Pearson correlation coefficient between the digital analysis of the PDS images and the digital analysis of the tissue sections was 0.81 (P < 0.01). Digital image analysis and qualitative grading by the examiner had a correlation of 0.89 by Spearman's (P < 0.01) for the PDS images. The correlation between the qualitative estimation of vascularity by the pathologist and the digital image analysis was 0.88 by Spearman's (P < 0.01).Conclusion. In the present study, PDS proved to be a reliable diagnostic method for qualitative grading of the vascularity of the synovial tissue. In clinical practice, PDS allows further differentiation of the hypertrophic synovium.

Knee osteoarthritis. Efficacy of a new method of contrast-enhanced musculoskeletal ultrasonography in detection of synovitis in patients with knee osteoarthritis in comparison with magnetic resonance imaging

“…Synovial hypertrophy in the superior and lateral recess was found in 59%, which is similar to the results by Walther et al ,22 who found 46% of patients with OA had hypertrophic synovial tissue by US examination.…”

“…Other studies were not complete in regards to CE-MUS with PD and comparison with MRI: in some studies, the knee or finger joints rheumatoid arthritis patients were investigated without using MRI as a reference standard 15 – 18 22. Another study used MRI in patients with knee OA without using PD or CE-MUS 23.…”

The pathogenesis of bone erosions in gouty arthritis

“…Power Doppler or colour Doppler US is a valuable tool for assessing hyperaemia of synovial tissue. Doppler US findings correlate closely with histopathological findings of vascularity68 and also with arthroscopic vessel scores 69. No such studies have been published in gouty arthritis to date.…”

Evaluation of several ultrasonography scoring systems for synovitis and comparison to clinical examination: results from a prospective multicentre study of rheumatoid arthritis

“…Ultrasonography scanning techniques, greyscale and power Doppler machine settings and definitions of abnormality were standardised among investigators prior to the study during a 1.5-day meeting. The US scanning method has been described previously 5 18–22. Synovitis was defined according to the OMERACT published definitions 19 20 23 24.…”