Diagnostic accuracy of ultrasonography in the assessment of anterior knee pain.
Anterior knee pain
Diagnostic accuracy
Knee joint
Magnetic resonance imaging
Ultrasonography
Journal
Insights into imaging
ISSN: 1869-4101
Titre abrégé: Insights Imaging
Pays: Germany
ID NLM: 101532453
Informations de publication
Date de publication:
01 Oct 2020
01 Oct 2020
Historique:
received:
29
07
2020
accepted:
16
09
2020
entrez:
1
10
2020
pubmed:
2
10
2020
medline:
2
10
2020
Statut:
epublish
Résumé
Anterior knee pain (AKP) is a problematic complaint, considered to be the most frequent cause of orthopedic consultancy for knee problems. This study aimed to highlight diagnostic accuracy of ultrasonography as a fast imaging technique in assessment of patients with AKP. A prospective study was conducted on 143 patients with clinically confirmed AKP. All patients underwent ultrasonography and MRI examinations of the knee. The diagnostic accuracy of ultrasonography compared to MRI for evaluating different findings of possible causes of AKP were analyzed using receiver operating characteristic (ROC) curve and judged by area under curve (AUC). A total of 155 knees were included in the study; 26 knees showed no abnormalities, 19 knees showed positive MRI only, and 110 knees showed positive ultrasonography and MRI. Ultrasonography and MRI reported 11 different findings of possible causes of AKP or related to it. Joint effusion was the most common finding (38%) followed by trochlear cartilage defect (20.6%) and superficial infrapatellar subcutaneous edema (20%). The overall accuracy of ultrasonography was 85.3% sensitivity and 100% specificity. The ultrasonography provided the highest sensitivity (100%) in detecting bipartite patella, followed by 91.5% for joint effusion, and 87.5% for quadriceps tendinopathy. The ROC curve analysis of overall accuracy of ultrasonography showed an AUC of 0.93. The overall Kappa agreement between ultrasonography and MRI was good (k = 0.66). Ultrasonography can be used to make a swift screening and assessment of painful anterior knee and as an alternative to MRI when it is unavailable or contraindicated.
Sections du résumé
BACKGROUND
BACKGROUND
Anterior knee pain (AKP) is a problematic complaint, considered to be the most frequent cause of orthopedic consultancy for knee problems. This study aimed to highlight diagnostic accuracy of ultrasonography as a fast imaging technique in assessment of patients with AKP.
METHODS AND RESULTS
RESULTS
A prospective study was conducted on 143 patients with clinically confirmed AKP. All patients underwent ultrasonography and MRI examinations of the knee. The diagnostic accuracy of ultrasonography compared to MRI for evaluating different findings of possible causes of AKP were analyzed using receiver operating characteristic (ROC) curve and judged by area under curve (AUC). A total of 155 knees were included in the study; 26 knees showed no abnormalities, 19 knees showed positive MRI only, and 110 knees showed positive ultrasonography and MRI. Ultrasonography and MRI reported 11 different findings of possible causes of AKP or related to it. Joint effusion was the most common finding (38%) followed by trochlear cartilage defect (20.6%) and superficial infrapatellar subcutaneous edema (20%). The overall accuracy of ultrasonography was 85.3% sensitivity and 100% specificity. The ultrasonography provided the highest sensitivity (100%) in detecting bipartite patella, followed by 91.5% for joint effusion, and 87.5% for quadriceps tendinopathy. The ROC curve analysis of overall accuracy of ultrasonography showed an AUC of 0.93. The overall Kappa agreement between ultrasonography and MRI was good (k = 0.66).
CONCLUSION
CONCLUSIONS
Ultrasonography can be used to make a swift screening and assessment of painful anterior knee and as an alternative to MRI when it is unavailable or contraindicated.
Identifiants
pubmed: 33000350
doi: 10.1186/s13244-020-00914-2
pii: 10.1186/s13244-020-00914-2
pmc: PMC7527384
doi:
Types de publication
Journal Article
Langues
eng
Pagination
107Références
Clin Med Insights Arthritis Musculoskelet Disord. 2019 Sep 05;12:1179544119872972
pubmed: 31523134
Knee Surg Sports Traumatol Arthrosc. 2005 May;13(4):268-72
pubmed: 15678298
Surg J (N Y). 2017 Feb 15;3(1):e9-e16
pubmed: 28825013
Ann Transl Med. 2019 Feb;7(4):71
pubmed: 30963066
Diagn Interv Imaging. 2017 Apr;98(4):339-345
pubmed: 27666183
Knee Surg Sports Traumatol Arthrosc. 2014 Oct;22(10):2275-85
pubmed: 24760163
Am J Sports Med. 2007 Mar;35(3):427-36
pubmed: 17261569
Eur J Ultrasound. 2001 Jul;13(3):183-9
pubmed: 11516628
Semin Musculoskelet Radiol. 2007 Jun;11(2):137-48
pubmed: 18095246
Biometrics. 1988 Sep;44(3):837-45
pubmed: 3203132
J Ultrasound. 2019 Dec;22(4):423-431
pubmed: 31069756
Ultrasound Med Biol. 2017 Jan;43(1):370-374
pubmed: 27743725
J Clin Ultrasound. 2003 Feb;31(2):85-97
pubmed: 12539250
Knee. 2018 Mar;25(2):279-285
pubmed: 29525550
J Ultrasound. 2015 Apr 18;18(3):251-7
pubmed: 26261475
J Clin Imaging Sci. 2014 Aug 30;4:45
pubmed: 25250194
Radiographics. 1997 May-Jun;17(3):675-91
pubmed: 9153705
Sports Health. 2017 Jul/Aug;9(4):346-351
pubmed: 27920260
Knee Surg Sports Traumatol Arthrosc. 2001 Jul;9(4):221-4
pubmed: 11522078
Sports Health. 2015 Sep-Oct;7(5):415-20
pubmed: 26502416
AJR Am J Roentgenol. 2013 Mar;200(3):W291-6
pubmed: 23436874
J Orthop Surg Res. 2018 Jul 16;13(1):178
pubmed: 30012149
J Ultrasound. 2020 Mar;23(1):45-53
pubmed: 30927249
Knee Surg Sports Traumatol Arthrosc. 2006 Mar;14(3):264-72
pubmed: 16133440
Am J Sports Med. 2002 Jul-Aug;30(4):488-91
pubmed: 12130402
Insights Imaging. 2016 Jun;7(3):373-83
pubmed: 27000624
Skeletal Radiol. 2014 Jul;43(7):875-93
pubmed: 24473994
J Ultrasound. 2016 May 25;19(3):197-201
pubmed: 27635165