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Abstract
Background: Osteoarthritis is the most frequent disease of the musculoskeletal system. The knee is one of the most common joint involved in OA. Pain, stiffness and physical disability are the major symptoms of knee OA and should be assessed when evaluating the impact of OA. OA is often associated with deposition of crystalline material within cartilage and periarticular structures. Musculoskeletal ultrasound (MUS) is an imaging modality that offers assessment of crystal deposition in patients with OA. Objectives: To assess the contribution of crystal deposits to the pain and functional disability in patients with knee OA using MUS as a diagnostic measure. Results: 51 (96.2%) patients had bilateral knee OA and 2 (3.7 %) patients had unilateral knee OA. Age of patients ranged from 38 to 67 years with a mean ± SD (53.5 ± 8.3). The disease duration ranged from 1 to 240 months with a mean ± SD (42.5 ± 49.5), body mass index (BMI) ranged from 24.2 to 53.3 with a mean ± SD (34.9 ± 6.3). All patients had history of intake of NSAIDS. WOMAC pain score ranged from 5-20 with a mean ± SD (14.5 ± 3.9), WOMAC stiffness score ranged from 0-8 with a mean ± SD (4.9 ± 2.1), WOMAC disability score ranged from 14- 67 with a mean ± SD (49. 7 ± 13.2). Among the 106 knees examined, sonographic evidence of crystal deposition was detected in 73 knees (68.9 %). Functional evaluation as measured by WOMAC was significantly different in the knees with ultrasonographic diagnosed crystal deposition and those without. The WOMAC pain, stiffness and disability scores were significantly higher in the knees with crystal deposition as compared to those without (p= 0.00 for each). By ultrasonography, the presence of osteophytes, effusion and bursitis were statistically significantly higher in knees with crystal deposition than those without (p = 0.03, 0.01 and 0.00 respectively). There was no statistical significant difference between both groups regarding the presence of synovial hypertrophy meniscal degeneration and loose bodies (p = 0.34, 0.25 and 0.24 respectively). Incidence of ultrasonographic detected bursitis was significantly higher 4.1 times in knees with ultrasonographic diagnosed crystal deposition than knees without (p=0.01), incidence of ultrasonographic detected effusion was significantly higher 3.2 times in knees with ultrasonographic diagnosed crystal deposition than knees without (p=0.01).