Color Doppler Ultrasound on Knee Osteoarthritis and Rheumatoid Arthritis Diagnosis and Differential
|Course||Medical Imaging and Nuclear Medicine|
|Keywords||Ultrasound Rheumatoid arthritis Osteoarthritis Knee lesions|
Objective: To evaluate color Doppler imaging (CDFI) in the differential diagnosis of knee osteoarthritis (OA) and rheumatoid arthritis (RA) lesions. Methods: by color Doppler ultrasound of the the OA case group (41 cases) and the RA patient group (35 cases) the thickness of the patient's cartilage and synovial thickness were compared SEQUOIA 512 color Doppler ultrasonic diagnostic apparatus, 8 - 14MHz, skeletal muscle conditions. Patients were sitting knees naturally bend (45 ° to 90 °), multi-slice examination of the knee joint, bilateral control suprapatellar bursa fluid thickness and sound transmission, observed from multiple perspectives, whether knee effusion, patellar bursa synovial thickness articular surface smoothness of the femoral cartilage thickness and subchondral bone damage to the medial femoral condyle and lateral condyle cartilage thickness, whether the soft tissue lesion, presence or absence of vascular injury, thrombosis, dynamic observation of muscle wins ligament, popliteal fossa cyst, meniscal and articular cavity selected laboratory data C-reactive protein (CRP), rheumatoid factor (RF), erythrocyte sedimentation rate (ESR) and RA, OA make a correlation analysis. Results: 1.35 RA patients in 70 knees normal 10 knees, 60 knees were found varying degrees of abnormal changes; 82 knees in 41 patients with OA patients have normal seven knees, 75 knees were found in varying degrees of abnormal changes. RA and OA groups suprapatellar bursa effusion and synovial thickening was significantly higher than the normal group; two groups femoral condyle at the cartilage thickness was significantly thinner than the normal group, and the the OA group femur condyle bone destruction was significantly higher than the outside condyle. Visible synovial localized or diffuse thickening 2.RA group, 30 patients with synovial pannus formation; fuzzy articular cartilage and subchondral bone articular surface contour articular surface rough and uneven, cortical defects; seen in the OA group slide film slightly thickened, 12 patients no synovial pannus formation; cartilage hypoechoic band echo uneven, messy and thinning fuzzy leading edge; visible hypoechoic band disappears, the local discontinuity subchondral bone; joint effusion, meniscal and ligament change in no significant difference between the OA group and the RA group. 3 color Doppler ultrasound can show the shape and size of the popliteal cyst wall and intracavitary. The OA group observed in this study 38 patients had popliteal cyst, 31 patients in the RA group, description of osteoarthritis and rheumatoid arthritis have popliteal cyst and the proportion of 92.7% and 88.6%. The knee effusion degree of inflammatory markers ESR 4.RA group of 35 cases related (P <0.05), no correlation with the RF titer. OA group of 41 patients, ESR normal, CRP is not elevated, RF negative. 5.RA and OA group, 76 patients with knee X-ray film is no exception, ultrasound examination showed joint effusion, synovial thickening, cartilage thickening part of the thickness of the articular cartilage thinning and subchondral bone destruction, ultrasound changes can occur in the X-ray changes. Conclusion: Color Doppler ultrasound by observing the knee joint effusion, synovium, cartilage and subchondral bone changes in the degree of location, indicating that ultrasound has some value and differential diagnosis of OA and RA. Color Doppler ultrasound diagnosis of knee OA patients with cartilage and bone destruction was significantly higher than that in patients with RA, knee OA disease specific changes. Color Doppler ultrasound diagnosis of RA patients with knee the synovial thickening higher than OA patients, synovial lesions is one of the basis of the diagnosis of RA. Thickening of the synovial pannus formation is also one of the pathological features of RA. 4.RA in patients with knee effusion higher incidence of fluid volume change associated with ESR, can be used as one of the the condition changes observed indicators. OA no specific laboratory findings. 5 Color Doppler ultrasound knee effusion is a simple, non-invasive, fast, early diagnosis, Efficacy will be regular follow-up help, and worthy of further promotion in clinical.