Sonography for hip joint effusion in adults with hip pain

Bierma-Zeinstra, S.; Bohnen, Arthur M.; Verhaar, Jan A N; Prins, A; Ginai-Karamat, A Z; Laméris, Johan S.

doi:10.1136/ard.59.3.178

Cited by 58 publications

(42 citation statements)

References 17 publications

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“…Several clinical studies done in patients with JRA have shown that the knee is the joint most frequently affected 16. History-taking and physical examination supplemented with radiological investigation are the usual tools to make the diagnosis of JRA 17. Radiographic changes mostly represent late and indirect signs of synovial disease 18…”

Section: Discussionmentioning

confidence: 99%

Clinical, Laboratory, and Ultrasound Assessment of the Knee in Juvenile Rheumatoid Arthritis

Algergawy

Haliem

Al-Shaer

2011

Clin Med�Insights�Arthritis�Musculoskelet Disord

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Background:The aim of this work was to study the ultrasonographic (USG) features of knee joints in relation to clinical and laboratory measures in patients with juvenile rheumatoid arthritis (JRA), and also to evaluate the accuracy of ultrasound in the diagnosis of local joint activity.Methods:This study included 20 with JRA and 20 matched and apparently healthy controls. All patients were subjected to full history taking, careful clinical examination and laboratory investigation. The knee joints of all patients and control were examined with plain radiography and ultrasonography on the same day of clinical examination using ultrasound to detect synovial thickness and effusion at the knee.Results:Mean USG knee synovial thickness was significantly greater in JRA patients versus controls (4.2 ± 2.4 mm versus 1.7 ± 0.3 mm, P < 0.001). Although knee effusion was not detected in any of the controls, it was demonstrated in 90% of JRA patients, with a mean effusion volume of 3.8 ± 3.1 mL. There was a statistically significant difference (P < 0.001) between clinically active and inactive knees with regard to knee synovial thickness. Mean knee effusion volume was significantly (P < 0.05) higher in the clinically active than in the clinically inactive knees. Patients with high disease activity had a significantly (P < 0.05) higher knee synovial thickness and knee effusion volume than patients with low and moderate disease activity. Significantly (P < 0.05) positive correlations were found between knee synovial thickness and articular index (AI) scores, disease activity score, clinical knee scores, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels. Significant positive correlations (P < 0.05) were found between knee effusion volume and AI scores, visual analog scores, disease activity scores, clinical knee scores, ESR, and CRP levels. Significant negative correlations (P < 0.05) were found between knee effusion volumes and hemoglobin levels.Conclusion:UGS-detected parameters represent a reliable index of JRA disease activity with a higher sensitivity for knee synovial thickness and higher specificity for knee effusion.

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Section: Discussionmentioning

confidence: 99%

Clinical, Laboratory, and Ultrasound Assessment of the Knee in Juvenile Rheumatoid Arthritis

Algergawy

Haliem

Al-Shaer

2011

Clin Med�Insights�Arthritis�Musculoskelet Disord

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“…È importante ricordare che il costo di un esame US è circa il 10% di quello di un esame RM. L'US rappresenta quindi un'alternativa economicamente vantaggiosa ed altamente indicativa per lo studio delle articolazioni (12,13). Inoltre la tecnica US permette una dettagliata valutazione della cartilagine, possibile nelle piccole articolazioni, e la visualizzazione dei versamenti articolari e dalle proliferazioni sinoviali.…”

Section: Discussioneunclassified

“…L'US si è mostrata particolarmente utile nello studio del sistema muscolo-scheletrico poiché, in aggiunta a quanto ottenibile con le normali tecniche radiografiche, permette di evidenziare la presenza di versamento e di ipertrofia sinoviale e di visualizzare i tessuti molli periarticolari, in particolare le strutture capsulo-legamentose (4). Inoltre, nelle piccole articolazioni, l'esame ecografico può dimostrare alterazioni molto precoci della cartilagine articolare (12). Sebbene l'US muscolo-scheletrica sia normalmente utilizzata per la maggior parte delle articolazioni, poco è stato pubblicato riguardo ad una sua applicazione nello studio dell'anca ed in particolare nell'OA dell'adulto.…”

Section: L'unclassified

Correlation between radiologic and ultrasonographic patterns and clinical manifestations in symptomatic hip osteoarthritis

Migliore¹,

Tormenta²,

Iannessi³

et al. 2011

Reumatismo

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nica. Infatti la tecnica radiografica permette di individuare alterazioni di margini, struttura ossea ed ampiezza dello spazio articolare, corrispondenti al decorso naturale della patologia. Tuttavia l'OA comporta alterazioni di tessuti quali la cartilagine articolare, la capsula, il liquido e la membrana sinoviali, non individuabili attraverso l'esame radiografico. Tali elementi dell'articolazione possono essere visualizzati attraverso altre metodiche, delle quali la più economica e facilmente reperibile è l'ecografia (ultrasonografia: US) (1). Poter individuare alterazioni a livello di queste strutture dell'articolazione può avere un ruolo di supporto nella valutazione clinica e nel trattamento dei sintomi relativi all'OA (2). Negli ultimi dieci anni, l'ecografia è stata ampiamente accettata come una delle principali tecniche INTRODUZIONE L'osteoartrosi (OA) è una malattia articolare cronica caratterizzata da lesioni degenerative e produttive a carico della cartilagine delle articolazioni diartrodiali. L'OA dell'anca rappresenta una fonte di disabilità e di spesa sociale maggiore rispetto a quelle dovute all'interessamento di altre articolazioni. Le manifestazioni radiologiche dell'OA sono universalmente note nella pratica cli- Reumatismo, 2007; 59(1):57-65 SUMMARY Increasing amounts of data have recenlty been published regarding ultrasonographic (US) findings of osteoarthritic joints, but very few data concern hip joints. In the current study we described US patterns concerning 490 patients affected by symptomatic hip osteoarthritis (OA) who underwent to intra-articular injections of hyaluronic products under US guidance. All patients were studied by US and X-ray of hip, clinical evaluation was assessed by the followings indexes: Lequesne, pain VAS, ICED, Global Physician Assessment and Global Patient

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“…Joint effusion is diagnosed when the distance between the anterior layer of synovium and the femoral neck is greater than 7 mm, or a difference between both hips is greater than 1 mm [2]. The presence of hip effusion is found frequently in the adults suffering from hip pain [3]. A US-guided aspiration of joint effusion for diagnostic or therapeutic purposes can be performed in this longitudinal-oblique plane along the axis of the femoral neck.…”

Section: Anterior Hip Acetabulum and Hip Joint Recessmentioning

confidence: 99%