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Journal of Ultrasound in Medicine, Vol 13, Issue 11 855-862, Copyright © 1994 by American Institute of Ultrasound in Medicine
Prospective sonographic and arthroscopic evaluation of proliferative knee joint synovitis
L. Rubaltelli, U. Fiocco, L. Cozzi, M. Baldovin, C. Rigon, P. Bortoletto, A. Tregnaghi, P. L. Melanotte, C. di Maggio and S. Todesco
Institute of Radiology, University of Padova, Italy.
The objective of this study was to verify the accuracy of ultrasonography
in assessing the topography, morphology, and extent of synovial
proliferation in rheumatoid and psoriatic knee joint synovitis. Findings
were compared to those obtained using prospective arthroscopy as the gold
standard; in addition, topographically defined sonographic findings before
and after arthroscopic synovectomy were compared. Sonographic examination
was performed in 12 patients with rheumatoid arthritis (13 knees) and 13
patients with psoriatic arthritis (14 knees) who had synovitis of the knee
using an electronic linear transducer (7.5 MHz) or a mechanical sector
transducer (10 MHz). This examination was followed within 1 week by
arthroscopy, to compare the topography (intra-articular localization) and
the morphology (sonographic patterns) of synovial proliferation. In 15
knees undergoing arthroscopic synovectomy, preoperative sonographic
measurement of synovial thickness in the suprapatellar, medial
parapatellar, and lateral parapatellar recesses was compared with
arthroscopic visualization of synovial proliferation; 13 knees were
reevaluated 2 months after arthroscopic synovectomy by sonography at the
same sites. Three distinct sonographic patterns of synovial proliferation
were confirmed by arthroscopic examination: a villonodular aspect in 12
knees; uniform thickening in eight knees, and overlapping layers in seven
knees. About 50% of the knees showed more than one sonographic pattern,
with no differences in pattern distribution between rheumatoid arthritis
and psoriatic arthritis patients. A significant correlation was found
between sonographic and arthroscopic evaluations of synovial thickness in
the suprapatellar (P < 0.02) and medial parapateoffr recesses (P <
0.02), the sites of maximal synovial proliferation in our
patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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