Diagnosis of Knee Osteochondral Lesions With Ultrasound Imaging

Abstract

Evaluation of articular cartilage and subchondral bone is essential in the diagnosis of joint diseases and injuries. Interobserver and intraobserver reproducibilities of arthroscopic grading are only poor to moderate. Thus, for quantitative and objective evaluation of cartilage and subchondral bone, ultrasound arthroscopy (UA) has been introduced to clarify this dilemma. Assessment of the clinical feasibility of high-frequency ultrasonography (US) during 6 knee arthroscopies was conducted, and the surgical technique is presented. US imaging was conducted with a flexible 9-MHz US catheter inserted into the joint through conventional portals. US and arthroscopy videos were synchronously recorded, and US parameters for cartilage and subchondral bone characteristics were measured. Arthroscopy and US imaging were combined to perform cartilage grading. UA produced quantitative data on lesion size, as well as cartilage quality, and showed subchondral bone changes. Visualization of an osteochondritis dissecans lesion not detected by conventional arthroscopy and US-guided retrograde drilling were possible with UA. To conclude, UA proved to be clinically feasible and aided in the diagnosis when assessing knee osteochondral lesions.

Interrater and Intrarater Reliability of Arthroscopic Measurements of Articular Cartilage Defects in the Knee

“…Surgeons frequently rely on postdebridement arthroscopic measurement of defects, and a variety of methods are commonly used to estimate size. Despite new imaging modalities, many surgeons believe that use of measuring devices during arthroscopic surgery is necessary for achieving accurate lesion measurement 15,[25][26][27] .…”

“…Therefore, the gold standard for sizing cartilage defects of the knee has been the direct measurement of defect size during arthroscopic knee surgery, commonly based on post-debridement arthroscopic sizing. Novel sizing methods, such as ultrasound examination, have been introduced as clinically feasible mechanisms for the diagnosis of cartilage lesions at the time of arthroscopy, but direct visual measurement still remains the gold standard 15 . The reported accuracy of arthroscopic sizing of defects varies in the current literature 16 .…”

Quantifying Complex Micro‐Topography of Degenerated Articular Cartilage Surface by Contrast‐Enhanced Micro‐Computed Tomography and Parametric Analyses

“…Hacker 856 et al 14 and Trudel et al 15 demonstrated a histologybased approach to compare AC surface topography against reference points on the AC surface. Furthermore, evaluation of AC surface roughness has been determined from image information obtained by ultrasound microscopy, [16][17][18] intravascular ultrasound, 19,20 and optical coherence tomography (OCT). 21,22 The most common clinically used imaging modality to quantify topography of degeneration is magnetic resonance imaging (MRI).…”

Fabella Syndrome: A Typical Case of Misdiagnosis and Discussion

“…To demonstrate articular cartilage surface using computerized tomography arthrography is the best choice, magnetic resonance is imaging technique through which demonstration of all tissue can be achieved (Figure 3) [59]. The US is used for assessment of both chondral and subchondral tissue components [62].…”