高频超声在膝关节骨关节炎早期诊断中的临床应用

目的探讨高频超声在膝关节骨关节炎（OA）早期诊断中的临床应用价值。方法收集2008年至2011年在本组临床诊断为早期OA的38例76个膝关节，对其超声检查及x线检查结果进行回顾性分析。结果早期OA患者中，软骨改变为超声检查中显示率最高的声像特点，超声能较清晰、准确显示软骨内部回声改变、软骨厚度变化及半月板变性。同时行超声检查和X线检查的38例患者中，超声检查检出病变35例患者（92．1％），76个膝关节中有70个（92．1％）检出病变；X线检查检出病变12例（31．5％），21个膝关节（27．6％）检出病变。两者间病例检出率有统计学差异（x^2=22．0，P〈0．05），以超声较高（92．1％vs34．3％）；超声关节病变检出率比X线检查高（90．7％w27．6％），差别有统计学意义（x^2=45．3，P〈0．05）。结论早期OA患者有特征性的超声声像改变，高频超声上在膝关节早期OA的诊断中具有重要的临床价值。

High frequency ultrasound for early diagnosis of knee osteoarthritis

Objective To investigate the clinical value of high frequency ultrasound in the diagnosis of early knee osteoarthritis. Methods 38 patients with 76 knees were collected, who was diagnosed as early knee joint osteoarthritis in our hospital from 2008 to 2011. The ultrasound and X-ray examination results were analyzed retrospectively. Results In early osteoarthritis, cartilage changes showed the highest rate of visualization in the ultrasound. Ultrasound could present more clear and accurate echo changes of internal cartilage, cartilage thickness and meniscal degeneration. Among the 76 knees of 38 patients who were examined by both ultrasound and X-ray, there were 70 joints （92. 1% ） with lesion in 35 patients （92. 1% ） detected by ultrasonography and 21 joints （27.6%） with lesion in 12 patients （31.5%） detected by X-ray. The difference of detectable rates of patient with joint lesion between these two methods was statistically significant （ X2 = 22. 0, P 〈 0. 05 ）, and the detectable rate was higher by uhrasonography （92. 1% vs 34. 3% ）. The difference of detectable rates of joint with lesion between these two methods was statistically significant （ Z2 = 45.3, P 〈 0. 05 ）, and the detectable rate was higher by ultrasonography （ 90. 7% vs 27. 6% ）. Conclusions Early osteoarthritis （ OA ） of the knee have characteristic uhrasonographic changes. High frequency ultrasonography has important clinical value in diagnosis of early stage OA.