Turning the Page in Osteoarthritis Assessment with the Use of Ultrasound
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IMAGING (J SAMUELS, SECTION EDITOR)
Turning the Page in Osteoarthritis Assessment with the Use of Ultrasound Amanda E. Nelson 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review This narrative review summarizes the last 5 years of published, peer-reviewed research on the use of musculoskeletal ultrasound (US) in osteoarthritis (OA). Recent Findings Multiple features relevant to OA can be visualized on US, including synovitis, erosion, enthesitis, osteophytes, cartilage damage, meniscal extrusion, and popliteal cysts. US can be used to confirm a diagnosis of OA or make an alternate diagnosis in the clinical setting. When a standardized protocol is used, US is a reliable modality for assessment of the features of OA. Findings on US can predict progression and response to therapy in OA of the hand and knee and can allow characterization of risk factors in a cost-effective, non-invasive, repeatable manner. Summary US is becoming more widely used in OA imaging and has clear value in addition to radiography and clinical assessment. US will likely prove useful in defining phenotypes and providing treatment guidance in OA. Keywords Ultrasound . Osteoarthritis . Imaging . Osteophytes . Cartilage . Synovitis
Introduction Osteoarthritis (OA) is the most common form of arthritis and is a frequent contributor to disability [1] that will affect 25–50% of US adults by age 85 [2–4]. Imaging, most commonly radiography, is frequently used in OA, whether to exclude alternate diagnoses, confirm the OA diagnosis in atypical presentations, or evaluate for concomitant pathologies or severity. However, radiography is insensitive to early changes of OA and to change over time, and this modality is not able to assess soft tissues or inflammation. Both magnetic resonance imaging (MRI) and ultrasound (US) allow imaging of a variety of features relevant to OA, including osteophytes, effusions, synovitis, enthesitis, bursitis, and cartilage pathology. To date, particularly in the USA, MRI has been more widely utilized in clinical and research settings for OA, although MRI is much more expensive and timeThis article is part of the Topical Collection on Imaging
consuming compared with US. In addition, MRI is not feasible in many common clinical settings, including for individuals with claustrophobia, larger body habitus, or metal implants. In contrast, US allows point-of-care assessment without radiation or need for contrast, can incorporate dynamic maneuvers as well as multiple joint assessments in a single visit, and is more costeffective than MRI. A recent systematic review summarized studies assessing the validity of US against radiography, MRI, histology, or arthroscopy of the knee, hand, and hip [5••]. At the knee, between US and radiography, there were strong correlations for osteophytes, moderate correlations for effusion and meniscal extrusion, but weak correlations for cartilage thickness. US and MRI at the knee generally demonstrated strong correlations. Fewer studies have considered v
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