퇴행성 슬관절염 환자의 초음파 소견과 통증 및 기능적 척도와의 연관성 (The Ultrasonographic Findings Related to Pain and Functional Status in Patients with Knee Osteoarthritis)

서지정보

· 발행기관 : 대한재활의학회
· 수록지 정보 : Annals of Rehabilitation Medicine / 32권 / 6호 / 668 ~ 681페이지
· 저자명 : 박경태, 김현정, 박혜경, 최남홍, 강윤주

초록

Objective: To evaluate the usefulness of ultrasonographic (US) examination in patients with knee osteoarthritis (OA) and determine US findings associated with pain and functional status.
Method: 45 patients with primary knee OA classified by the American College of Rheumatology (ACR) criteria were recruited. The severity of pain and functional status were measured by Lequesne index and Western Ontario and McMaster Universities Osteoarthritis Scores (WOMAC). All patients underwent US examination of their knees and plain radiography for Kellgren and Lawrence (KL) grade. Results: Even in mild OA cases (KL G1, 2), patients had evidence of distended suprapatellar pouch (effusion) (32%), synovial thickening (12%), cartilage degeneration (32%) and medial capsular distension (72%). The severity of pain and functional status were found to be correlated with following US findings: amount of suprapatellar effusion (γ=0.514, p＜0.01), degree of synovial thickness (γ=0.520, p＜0.01), cartilage degeneration grade (γ=0.594, p＜0.01), length of medial capsular distension (γ=0.426, p＜0.01). However, the length of medial and lateral osteophytes, size of Baker's cyst, and clinical parameter such as age, disease duration and BMI score were not correlated with the severity of pain and functional status in OA patients. Following multiple regression analysis, the amount of effusion, synovial thickness and length of medial capsular distension were correlated with Lequesne and WOMAC functional status score (γ2=0.635, p＜0.05). Conclusion: Ultrasonographic assessment was useful for diagnosing knee OA. The severity of pain and function were highly associated with the amount of suprapatellar effusion, degree of synovial thickness, the length of medial capsular distension and grade of cartilage degeneration.

영어초록

Objective: To evaluate the usefulness of ultrasonographic (US) examination in patients with knee osteoarthritis (OA) and determine US findings associated with pain and functional status.
Method: 45 patients with primary knee OA classified by the American College of Rheumatology (ACR) criteria were recruited. The severity of pain and functional status were measured by Lequesne index and Western Ontario and McMaster Universities Osteoarthritis Scores (WOMAC). All patients underwent US examination of their knees and plain radiography for Kellgren and Lawrence (KL) grade. Results: Even in mild OA cases (KL G1, 2), patients had evidence of distended suprapatellar pouch (effusion) (32%), synovial thickening (12%), cartilage degeneration (32%) and medial capsular distension (72%). The severity of pain and functional status were found to be correlated with following US findings: amount of suprapatellar effusion (γ=0.514, p＜0.01), degree of synovial thickness (γ=0.520, p＜0.01), cartilage degeneration grade (γ=0.594, p＜0.01), length of medial capsular distension (γ=0.426, p＜0.01). However, the length of medial and lateral osteophytes, size of Baker's cyst, and clinical parameter such as age, disease duration and BMI score were not correlated with the severity of pain and functional status in OA patients. Following multiple regression analysis, the amount of effusion, synovial thickness and length of medial capsular distension were correlated with Lequesne and WOMAC functional status score (γ2=0.635, p＜0.05). Conclusion: Ultrasonographic assessment was useful for diagnosing knee OA. The severity of pain and function were highly associated with the amount of suprapatellar effusion, degree of synovial thickness, the length of medial capsular distension and grade of cartilage degeneration.

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