Sep 2026· Journal of Clinical and Diagnostic Research· 0 citations
TL;DR
USG provides improved detection of osteophytes and offers additional information on soft-tissue and early structural changes in knee OA and serves as a valuable, accessible adjunct to conventional radiography for comprehensive evaluation and early diagnosis of knee OA.
Abstract
Introduction: Knee Osteoarthritis (OA) is a prevalent degenerative joint disorder and a major cause of pain and disability among the elderly population. Conventional radiography remains the standard imaging modality for diagnosis and grading; however, it has limited sensitivity in detecting early and soft-tissue changes. Ultrasonography (USG) has emerged as a useful, cost-effective adjunct for evaluating both osseous and periarticular soft-tissue abnormalities. Hence, there is a need to assess its diagnostic efficacy in comparison with radiography.
Aim: To compare the ultrasonographic features with radiographic grading (Kellgren-Lawrence) in patients with knee OA.
Materials and Methods: The present cross-sectional observational study was conducted in the Department of Orthopaedics at SRM Medical College Hospital and Research Institute, Kattankulathur, Chennai, Tamil Nadu, India. from May 2024 to August 2024. A total of 48 patients aged above 50 years fulfilling the American College of Rheumatology (ACR) criteria for knee OA were included. All patients underwent standing anteroposterior and lateral radiographs, graded using the Kellgren-Lawrence (KL) classification, followed by ultrasonographic evaluation using a high-frequency linear probe. Parameters studied included osteophytes, Joint Space Narrowing (JSN), cartilage thickness, joint effusion, Baker’s cyst, and meniscal protrusion. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software (version 22.0). McNemar’s test, Chi-square test, and paired t-test were applied. A p-value of <0.05 was considered statistically significant.
Results: The majority of patients were aged 60-69 years 20 (41.7%) with a female predominance 26 (54.2%). Most cases belonged to Kellgren-Lawrence (KL) Grade 2 18 (37.5%) and Grade 3 16 (33.3%). USG detected osteophytes in 44 (91.7%) of patients compared to 34 (70.8%) on radiography (p=0.004). JSN was observed in 38 (79.2%) by USG and 36 (75.0%) by radiography (p=0.62), showing no significant difference. Ultrasonographic findings such as reduced cartilage thickness 32 (66.7%), joint effusion 20 (41.7%), and meniscal protrusion 12 (25.0%) increased significantly with higher KL grades (p<0.05). Mean medial joint space measurements were comparable between modalities (p=0.48), whereas USG detected significantly reduced lateral joint space compared to radiography (p=0.03).
Conclusion: USG provides improved detection of osteophytes and offers additional information on soft-tissue and early structural changes in knee OA. It associates well with radiographic severity and serves as a valuable, accessible adjunct to conventional radiography for comprehensive evaluation and early diagnosis of knee OA.
Background: Knee osteoarthritis (OA) is a leading cause of pain and physical disability. A discordance often exists between radiological findings and clinical symptoms, creating a challenge in clinical decision-making. This study aimed to investigate the relationships among pain, physical disability, and radiographic findings in patients with knee Osteoarthritis (OA). Methods: A total of 113 patients with knee OA who attended the knee clinic of GMCTH were included in the study. A descriptive, cross-sectional study was conducted over 1 year. Radiographic grading was assessed with the use of the Kellgren-Lawrence scale. The severity of knee pain, stiffness and disability was measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).Results: BMI is a major risk factor for osteoarthritis. On radiographic assessment, 15 patients (13.27%) were grade 1, 45 (39.83%) were grade 2, 34 (30.09%) were grade 3, and 19 (16.81%) were grade 4, according to the KL grading system. Mean VAS score was 6.53 ± 1.33 and was significantly associated with KL grading when P<0.005. Kellgren-Lawrence grading scale andage or disease duration were positively and significantly associated. Conclusions: Knee pain, stiffness, and physical disability are significantly associated with radiological severity in knee osteoarthritis. There is a need for an integrated assessment combining clinical evaluation and radiological findings to guide treatment planning for patients with knee OA.
Krishna bahadur Bista, R. Dhakal, Bodh Raj Gautam et al.· A Bi-annual South Asian Jour...· 0 citations
Background: Subacromial impingement syndrome (SIS) is a leading cause of shoulder pain, accounting for nearly half of all shoulder complaints. Accurate diagnosis is essential, yet challenging due to anatomical complexity and overlapping symptoms. While physical examination (PE) remains crucial, magnetic resonance imaging (MRI) offers superior soft tissue assessment. This study aimed to evaluate the diagnostic accuracy of specific PE tests for SIS in comparison with MRI.
Methods: A cross-sectional study was conducted on 38 patients with shoulder pain presenting to the Department of Orthopaedics, Era’s Lucknow Medical College and Hospital, Lucknow, from May 2022 to May 2024. Patients underwent a series of PE manoeuvres including Passive abduction, Neer, Hawkins, Yocum, Jobe, Patte, Gerber, and Resisted abduction tests. MRI of the symptomatic shoulder was performed within five days of PE and interpreted by a blinded radiologist. Diagnostic performance of each PE test was evaluated using MRI as the reference standard.
Results: The mean participant age was 48.6 years; 63.16% were male. SIS was confirmed via MRI in 55.26% of participants. Among the PE tests, Passive abduction demonstrated the highest accuracy (68.42%), with sensitivity 72.00% and specificity 61.54%, and was the only test with statistically significant correlation to MRI (p=0.0448). Other tests such as Hawkins, Yocum, and Neer showed high sensitivity but lower specificity. The Patte test had the lowest diagnostic accuracy.
Conclusions: The Passive abduction test was the most reliable for diagnosing SIS. While some tests showed reasonable sensitivity, low specificity limited their overall accuracy. PE remains valuable but is best used in conjunction with MRI for optimal diagnosis.
Shubham Gupta, A. Anand, Yagya Vohra et al.· International Journal of Res...· 0 citations
Background: Meniscal tears are one of the most common internal derangements of the knee joint, and a major source of pain, swelling, locking and functional limitation. Magnetic Resonance Imaging (MRI) is a noninvasive examination commonly used to help assess meniscal injury, and arthroscopy is the definitive test. Determination of the accuracy of diagnosis by MRI is crucial for optimizing management of the patient and minimising invasive procedures. Methods: The study was a retrospective observational study carried out in the departments of Orthopaedics and Radiology of Patna Medical College & Hospital (PMCH) from May 2025 to November 2025. The study included a total of 94 patients with suspected meniscal injuries who had both MRI and arthroscopy. Comparisons were made between findings on MRI and arthroscopic findings, and diagnostic parameters were computed, such as sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), and overall accuracy. Results: MRI had high sensitivity and good diagnostic accuracy for the identification of meniscal tears. Medial meniscal tears were more common than lateral meniscal tears. The sensitivity, specificity, PPV, NPV, and overall accuracy of MRI were found to be 93.9%, 45.5%, 92.9%, 50.0%, and 88.3%, respectively. There was a strong correlation between MRI findings and arthroscopic findings. Conclusion: MRI is a useful, non-invasive imaging technique that is accurate and helpful for diagnosing meniscal tears, and is a valuable aid in the preoperative evaluation. But the gold standard in the definitive diagnosis and management of meniscal injury is still arthroscopy.
K. A. Lata, Anas Misbah, S. Pawar et al.· International Journal of Cur...· 0 citations
Introduction: Osteoarthritis (OA) of the knee is a common degenerative joint disorder and a leading cause of chronic pain, stiffness and disability among middle-aged and elderly individuals. Serum Uric Acid (SUA) has been suggested as a potential metabolic factor associated with OA severity.
Aim: To evaluate the association between SUA levels and the severity of knee OA and to assess their relationship with pain intensity and functional status.
Materials and Methods: This cross-sectional observational study was conducted in the Department of Orthopaedics, Maharishi Markandeshwar (MM) Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India, over a period of 18 months (January 2023 to June 2024). A total of 100 patients aged 40-70 years with clinically and radiologically confirmed OA of the knee were included. SUA levels were categorised as normal (<6 mg/dL), moderately elevated (6-8 mg/dL) and high (>8 mg/dL). Pain severity was assessed using the Visual Analogue Scale (VAS), functional status using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and radiological severity using the Kellgren-Lawrence (KL) grading system. Statistical analysis was performed using Stata version 17.0. Associations between variables were assessed using the Pearson’s Chi-square test, Analysis of Variance (ANOVA), while correlation analysis was performed to evaluate the relationship between SUA levels and WOMAC scores. A p-value <0.05 was considered statistically significant.
Results: The mean age of the participants was 57.65±5.65 years, with an age range of 48-68 years. Among the 100 participants, 37% had normal SUA levels, 35% had moderately elevated levels and 28% had high SUA levels. A significant association was observed between SUA levels and radiological severity of OA based on KL grading (χ2 =26.21, p=0.006). Higher SUA levels were also significantly associated with greater pain severity on the VAS scale (χ2 =16.15, p=0.013). Mean WOMAC scores increased progressively with rising SUA levels and a strong positive correlation was observed between SUA levels and total WOMAC score (r=0.67, p<0.001).
Conclusion: Elevated SUA levels are significantly associated with greater radiological severity, increased pain intensity and poorer functional status in patients with knee OA.
S. Jaura, Paarth Gautam, P. Tiwari et al.· Journal of Clinical and Diag...· 0 citations
Hand osteoarthritis (HOA) frequently coexists with knee osteoarthritis (KOA), yet its clinical and radiographic burden in ageing adults with KOA remains under-recognised. To determine the prevalence and joint-specific distribution of clinical, radiographic, and symptomatic HOA in individuals with KOA; to describe associated functional characteristics; and to assess whether HOA severity is related to KOA severity. A descriptive cross-sectional study was conducted among adults ≥ 40 years with tibiofemoral KOA (KL grades 1-4). HOA was evaluated using American College of Rheumatology criteria, hand radiographs (KL ≥ 2), and symptom-based definitions. Assessments included VAS pain, WOMAC, DASH, AUSCAN, grip strength, and pinch strength. Statistical analyses used Mann-Whitney U, Kruskal-Wallis, and χ² tests (α = 0.05). Among 108 participants (mean age 62.1 ± 11.0 years; 71.3% female), 16.7% reported hand symptoms. The prevalence of clinical, radiographic, and symptomatic HOA was 9.3%, 13.0%, and 8.3%, respectively. PIP and DIP joints were most frequently affected, with no MCP involvement. Knee KL grades clustered at grades 3-4 and were associated with significantly worse WOMAC, DASH, and AUSCAN scores. Symptomatic HOA was associated with reduced grip strength, while pinch strength remained unaffected. No significant association was observed between knee and hand KL grades. HOA is a common but under-recognised comorbidity in individuals with KOA, demonstrating predominant PIP/DIP involvement and measurable functional impact. The absence of structural correlation between knee and hand OA highlights OA as a multisite, heterogeneous degenerative condition of ageing. Routine hand assessment in KOA clinics may support earlier identification and targeted management of HOA.
V. Aggarwal, Charu Eapen, A. Prabhakar et al.· Scientific Reports· 0 citations
Background: Knee injuries are common musculoskeletal problems affecting stability, weight-bearing, and
movement. Trauma, sports activities, overuse, and degenerative changes contribute to internal derangements, and
accurate diagnosis is essential to prevent chronic pain, joint instability, and osteoarthritis. MRI is the preferred
imaging modality due to its ability to visualize both soft tissue and bony structures in multiple planes.
Objective: To retrospectively analyze MRI findings in patients with knee injuries and determine the frequency,
pattern, and associated abnormalities.
Methods: A ‘
retrospective observational study was conducted on 120 patients who underwent MRI for knee
injuries at Sonoscan Pvt.Ltd, Malda, West Bengal, India. Data on age, gender, clinical history, side of injury, and
MRI findings were collected using a structured data sheet. Standard MRI protocols including T1, T2, Proton
Density, and fat-suppressed sequences in sagittal, coronal, and axial planes were used. Descriptive statistics were
applied to assess the frequency and distribution of injuries.
Results: Most patients were males (65%), and the 21–30 years age group was most affected (30%). Right knee
injuries were slightly more frequent (56.7%). ACL tears (38.3%) and medial meniscus tears (33.3%) were the
most common injuries. Joint effusion (43.3%) and bone marrow edema (28.3%) were frequently associated
findings, while cartilage injuries were observed in 16.7% of cases.
Conclusion: MRI provides a detailed evaluation of knee injuries, aiding diagnosis and management. ACL and
medial meniscus injuries are predominant in young adults, and MRI detection of associated abnormalities helps
guide treatment and improve patient outcomes.
Abhishek Mishra, A. Singh· International Journal of Pha...· 0 citations
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