Ultrasounds outperform magnetic resonance imaging in quantifying meniscal extrusion in patients with knee osteoarthritis

Abstract Purpose The aim of this study was to quantify meniscal extrusion through ultrasound (US) evaluation in supine and standing positions and to compare the results with those documented through magnetic resonance (MR) imaging in patients affected by knee osteoarthritis (OA). Methods Sixty patie...

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Main Authors: Fabio Tortorella, Angelo Boffa, Luca Andriolo, Giancarlo Facchini, Maddalena Di Carlo, Marco Miceli, Burt Klos, Stefano Zaffagnini, Giuseppe Filardo
Format: Article
Language:English
Published: Wiley 2024-10-01
Series:Journal of Experimental Orthopaedics
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Online Access:https://doi.org/10.1002/jeo2.70031
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author Fabio Tortorella
Angelo Boffa
Luca Andriolo
Giancarlo Facchini
Maddalena Di Carlo
Marco Miceli
Burt Klos
Stefano Zaffagnini
Giuseppe Filardo
author_facet Fabio Tortorella
Angelo Boffa
Luca Andriolo
Giancarlo Facchini
Maddalena Di Carlo
Marco Miceli
Burt Klos
Stefano Zaffagnini
Giuseppe Filardo
author_sort Fabio Tortorella
collection DOAJ
description Abstract Purpose The aim of this study was to quantify meniscal extrusion through ultrasound (US) evaluation in supine and standing positions and to compare the results with those documented through magnetic resonance (MR) imaging in patients affected by knee osteoarthritis (OA). Methods Sixty patients (38 men, 22 women, mean age 60.8 ± 9.7 years) with knee OA were enrolled and underwent a 1.5 T MR evaluation and an US examination of the symptomatic OA knee for the evaluation of the medial and lateral meniscus extrusion both in the supine clinostatic position (clino‐US) with the knee fully extended and in the standing weight‐bearing orthostatic position (ortho‐US). For the three imaging evaluations (MR, clino‐US and ortho‐US), both semi‐quantitative and quantitative measurements were performed. Results The quantitative analysis documented higher values of medial meniscal extrusion at the ortho‐US evaluation (5.2 ± 2.3 mm) compared to MR (4.2 ± 2.2, p < 0.0005) and clino‐US (4.5 ± 2.3, p < 0.0005) and of the lateral meniscus at the ortho‐US evaluation (4.3 ± 1.8) compared to MR (3.3 ± 1.6, p < 0.0005) and clino‐US (3.8 ± 1.6, p < 0.0005). The semi‐quantitative analysis confirmed the same trend for both menisci. Higher extrusion values were documented in women and more advanced OA, as well as in older patients with higher body mass index, the latter being underestimated the most by the MR approach. Conclusion US outperforms MR imaging in quantifying meniscal extrusion in patients with knee OA. Moreover, the highest values of meniscal extrusion have been documented using US in standing position compared to the supine position, underlining the importance of the weight‐bearing assessment of meniscal extrusion in knee OA patients. Level of Evidence II.
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spelling doaj-art-2a289d4ca1264e898302a5d71db226ae2025-08-20T02:58:21ZengWileyJournal of Experimental Orthopaedics2197-11532024-10-01114n/an/a10.1002/jeo2.70031Ultrasounds outperform magnetic resonance imaging in quantifying meniscal extrusion in patients with knee osteoarthritisFabio Tortorella0Angelo Boffa1Luca Andriolo2Giancarlo Facchini3Maddalena Di Carlo4Marco Miceli5Burt Klos6Stefano Zaffagnini7Giuseppe Filardo8Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli Bologna ItalyClinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli Bologna ItalyClinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli Bologna ItalyRadiologia diagnostica ed interventistica, IRCCS Istituto Ortopedico Rizzoli Bologna ItalyRadiologia diagnostica ed interventistica, IRCCS Istituto Ortopedico Rizzoli Bologna ItalyRadiologia diagnostica ed interventistica, IRCCS Istituto Ortopedico Rizzoli Bologna ItalyICONE Orthopedics and Sports Traumatology Schijndel The NetherlandsClinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli Bologna ItalyApplied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli Bologna ItalyAbstract Purpose The aim of this study was to quantify meniscal extrusion through ultrasound (US) evaluation in supine and standing positions and to compare the results with those documented through magnetic resonance (MR) imaging in patients affected by knee osteoarthritis (OA). Methods Sixty patients (38 men, 22 women, mean age 60.8 ± 9.7 years) with knee OA were enrolled and underwent a 1.5 T MR evaluation and an US examination of the symptomatic OA knee for the evaluation of the medial and lateral meniscus extrusion both in the supine clinostatic position (clino‐US) with the knee fully extended and in the standing weight‐bearing orthostatic position (ortho‐US). For the three imaging evaluations (MR, clino‐US and ortho‐US), both semi‐quantitative and quantitative measurements were performed. Results The quantitative analysis documented higher values of medial meniscal extrusion at the ortho‐US evaluation (5.2 ± 2.3 mm) compared to MR (4.2 ± 2.2, p < 0.0005) and clino‐US (4.5 ± 2.3, p < 0.0005) and of the lateral meniscus at the ortho‐US evaluation (4.3 ± 1.8) compared to MR (3.3 ± 1.6, p < 0.0005) and clino‐US (3.8 ± 1.6, p < 0.0005). The semi‐quantitative analysis confirmed the same trend for both menisci. Higher extrusion values were documented in women and more advanced OA, as well as in older patients with higher body mass index, the latter being underestimated the most by the MR approach. Conclusion US outperforms MR imaging in quantifying meniscal extrusion in patients with knee OA. Moreover, the highest values of meniscal extrusion have been documented using US in standing position compared to the supine position, underlining the importance of the weight‐bearing assessment of meniscal extrusion in knee OA patients. Level of Evidence II.https://doi.org/10.1002/jeo2.70031extrusionmagnetic resonancemeniscusosteoarthritisultrasound
spellingShingle Fabio Tortorella
Angelo Boffa
Luca Andriolo
Giancarlo Facchini
Maddalena Di Carlo
Marco Miceli
Burt Klos
Stefano Zaffagnini
Giuseppe Filardo
Ultrasounds outperform magnetic resonance imaging in quantifying meniscal extrusion in patients with knee osteoarthritis
Journal of Experimental Orthopaedics
extrusion
magnetic resonance
meniscus
osteoarthritis
ultrasound
title Ultrasounds outperform magnetic resonance imaging in quantifying meniscal extrusion in patients with knee osteoarthritis
title_full Ultrasounds outperform magnetic resonance imaging in quantifying meniscal extrusion in patients with knee osteoarthritis
title_fullStr Ultrasounds outperform magnetic resonance imaging in quantifying meniscal extrusion in patients with knee osteoarthritis
title_full_unstemmed Ultrasounds outperform magnetic resonance imaging in quantifying meniscal extrusion in patients with knee osteoarthritis
title_short Ultrasounds outperform magnetic resonance imaging in quantifying meniscal extrusion in patients with knee osteoarthritis
title_sort ultrasounds outperform magnetic resonance imaging in quantifying meniscal extrusion in patients with knee osteoarthritis
topic extrusion
magnetic resonance
meniscus
osteoarthritis
ultrasound
url https://doi.org/10.1002/jeo2.70031
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AT lucaandriolo ultrasoundsoutperformmagneticresonanceimaginginquantifyingmeniscalextrusioninpatientswithkneeosteoarthritis
AT giancarlofacchini ultrasoundsoutperformmagneticresonanceimaginginquantifyingmeniscalextrusioninpatientswithkneeosteoarthritis
AT maddalenadicarlo ultrasoundsoutperformmagneticresonanceimaginginquantifyingmeniscalextrusioninpatientswithkneeosteoarthritis
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