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© 2008 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 27:729-736 • 0278-4297

Three-Dimensional Ultrasonographic Application for Analyzing Synovial Hypertrophy of the Knee in Patients With Osteoarthritis

Ji Hyeon Ju, MD, Kwi Young Kang, MD, In Je Kim, MD, Jang Uk Yoon, MD, Ho-Youn Kim, MD, PhD and Sung-Hwan Park, MD, PhD

Division of Rheumatology, Department of Internal Medicine, Kangnam St Mary’s Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.

Address correspondence to Sung-Hwan Park, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Center for Rheumatic Disease, Kangnam St Mary’s Hospital, College of Medicine, Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, Seoul 137-040, Korea. E-mail: rapark{at}catholic.ac.kr

Objective. The purpose of this study was to evaluate 3-dimensional (3D) ultrasonography for the visualization of intra-articular synovial hypertrophy in patients with osteoarthritis. Methods. Knee joints of 22 patients with osteoarthritis were examined by 3D ultrasonography, and their synovial fluids were analyzed. Ultrasonographic image patterns, vascular endothelial growth factor and transforming growth factor β concentrations in synovial fluid, and serum inflammatory markers were analyzed. Results. It was possible to visualize the intra-articular structure by 3D ultrasonography. Three-dimensional ultrasonography revealed various interesting stereoscopic views of the synovial structures, and the patterns of synovial proliferation ranged from simple proliferations to complex shrubby structures. Patients with a more complex and proliferative pattern in the synovium tended to have higher C-reactive protein concentrations, but this difference was not significant (P = .09). The concentrations of vascular endothelial growth factor and transforming growth factor β in synovial fluid were significantly higher in patients with complex hypertrophy (P < .05). Conclusions. Three-dimensional technology was useful in delineating the shape of the synovium. It may have a possible impact on future imaging in rheumatology.

Key Words: osteoarthritis • synovial hypertrophy • 3-dimensional ultrasonography

Abbreviations: CRP, C-reactive protein • ESR, erythrocyte sedimentation rate • NSAID, nonsteroidal anti-inflammatory drug • OA, osteoarthritis • 3D, 3-dimensional • TGF-β, transforming growth factor β • 2D, 2-dimensional • VAS, visual analog scale • VEGF, vascular endothelial growth factor

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Copyright © 2008 by the American Institute of Ultrasound in Medicine.