OBJECTIVE: To describe 1) a technique that can detect synovial effusions not seen on static ultrasound (US) examination and 2) the characteristics of patients with knee osteoarthritis (OA) for whom this technique proved useful. METHODS: From reviewed records of 76 patients with knee OA (112 knees) that we had seen for US-guided injections over a defined period, we found 45 knees with no detectable effusion on static US, of which 18 (14 patients) showed fluid when scanned during voluntary quadriceps contraction. For all patients, we had recorded effusion features (physical examination, presence and size on US), and success of joint entry was determined by getting synovial fluid and/or seeing an air echo or inflow of injected material. RESULTS: The 14 patients we studied were obese (mean +/- SEM body mass index 32.7 +/- 2.3 kg/m(2); 3 morbidly obese), with moderate to severe OA by radiography in most (Kellgren/Lawrence class 3 or 4 in 10 of 14 knees for which radiographs were available). The suprapatellar synovial space seen by US was small (mean +/- SEM depth 0.38 +/- 0.04 cm). Arthrocentesis obtained 0.5-16 ml of synovial fluid (mean +/- SEM 2.9 +/- 0.6 ml), which correlated with the depth of effusion as seen on US with the quadriceps in maximum contraction (Spearman's rho = 0.5597, P = 0.0157). In 4 knees where arthrocentesis failed to retrieve fluid, we observed at injection the inflow of material and a linear air echo. CONCLUSION: US of the knee during voluntary quadriceps contraction can find effusions not detectable on static US. Such effusions provide targets for accurate aspiration and injection that would not be appreciated with static US.
OBJECTIVE: To describe 1) a technique that can detect synovial effusions not seen on static ultrasound (US) examination and 2) the characteristics of patients with knee osteoarthritis (OA) for whom this technique proved useful. METHODS: From reviewed records of 76 patients with knee OA (112 knees) that we had seen for US-guided injections over a defined period, we found 45 knees with no detectable effusion on static US, of which 18 (14 patients) showed fluid when scanned during voluntary quadriceps contraction. For all patients, we had recorded effusion features (physical examination, presence and size on US), and success of joint entry was determined by getting synovial fluid and/or seeing an air echo or inflow of injected material. RESULTS: The 14 patients we studied were obese (mean +/- SEM body mass index 32.7 +/- 2.3 kg/m(2); 3 morbidly obese), with moderate to severe OA by radiography in most (Kellgren/Lawrence class 3 or 4 in 10 of 14 knees for which radiographs were available). The suprapatellar synovial space seen by US was small (mean +/- SEM depth 0.38 +/- 0.04 cm). Arthrocentesis obtained 0.5-16 ml of synovial fluid (mean +/- SEM 2.9 +/- 0.6 ml), which correlated with the depth of effusion as seen on US with the quadriceps in maximum contraction (Spearman's rho = 0.5597, P = 0.0157). In 4 knees where arthrocentesis failed to retrieve fluid, we observed at injection the inflow of material and a linear air echo. CONCLUSION: US of the knee during voluntary quadriceps contraction can find effusions not detectable on static US. Such effusions provide targets for accurate aspiration and injection that would not be appreciated with static US.
Authors: Tej B Bhavsar; Wilmer L Sibbitt; Philip A Band; Romy J Cabacungan; Timothy S Moore; Luis C Salayandia; Roderick A Fields; Scarlett K Kettwich; Luis P Roldan; N Suzanne Emil; Monthida Fangtham; Arthur D Bankhurst Journal: Clin Rheumatol Date: 2017-09-14 Impact factor: 2.980
Authors: Fabian Proft; Mathias Grunke; Christiane Reindl; Markus A Schramm; Felix Mueller; Maximilian Kriegmair; Jan Leipe; Peter Weinert; Hendrik Schulze-Koops; Matthias Witt Journal: BMC Musculoskelet Disord Date: 2016-07-11 Impact factor: 2.362
Authors: A Saito; K Okada; I Saito; K Kinoshita; A Seto; Y Takahashi; K Shibata; H Sato; M Wakasa Journal: J Musculoskelet Neuronal Interact Date: 2016-12-14 Impact factor: 2.041
Authors: Garifallia Sakellariou; Carlo Alberto Scirè; Antonella Adinolfi; Alberto Batticciotto; Alessandra Bortoluzzi; Andrea Delle Sedie; Orazio De Lucia; Christian Dejaco; Oscar Massimiliano Epis; Emilio Filippucci; Luca Idolazzi; Andrea Picchianti Diamanti; Alen Zabotti; Annamaria Iagnocco; Georgios Filippou Journal: Front Med (Lausanne) Date: 2020-05-07