The Role of Ultrasonography in Diagnosis of Knee Diseases

Abstract

Ultrasonography is the most rapidly developing technique in musculoskeletal imaging. It is a noninvasive imaging modality used for the assessment of the musculoskeletal system. It can provide clinically useful information on a wide range of pathologic conditions affecting components of the knee joint, including the tendons, ligaments, muscles, synovial space, articular cartilage, and surrounding soft tissues (Jon A. Jacobson 2013). Anterior knee pain is one of the most common complaints encountered by the orthopedist. Ultrasound provides an excellent non– invasive method in helping to differentiate patellofemoral problems including the common chondromalacia patella, from abnormalities involving the extensor mechanism (Friedman &Chhem 2005). The ability to assess the tendons of the extensor mechanism of the knee is one of the particular strengths of ultrasound as it is able to accurately evaluate tendinosis, tendon tear and rupture (Rumack et al. 2011). The collateral ligaments of the knee are easier to visualize with ultrasound than the cruciate ligaments due to their superficial location. Comparison with findings for the normal contralateral ligament is advisable to confirm the diagnosis (Abdel Razek et.al 2009). Summary 103 Ultrasound can be used in the setting of rheumatoid arthritis from early diagnosis, to assessment of severity, Color and power Doppler techniques can be used to measure neovascularization within the synovial lining of the joints, tendons, and soft-tissue masses (Chiara Rizzo et al 2013). Ultrasound can suggest an early diagnosis of osteoarthritis by demonstrating joint effusion, synovial thickening, bony changes, patellofemoral changes, articular cartilage changes, meniscal pathologies, such as meniscal cysts, and Baker cyst. Pathologies can be detected by ultrasound at a stage in which plain radiographs still appear normal (Alexander Blankstein 2011). Ultrasound can differentiate cystic lesions from solid masses, but malignant and benign masses cannot be distinguished on the basis of their sonographic appearances. Standard characteristics such as size, shape, location, and echogenicity can be determined with ultrasound (Bianchi & Martinoli 2007). Ultrasound can be used to assess the popliteal vessels. Power and Color Duplex ultrasound can differentiate between patent and thrombosed artery and for the detection of thrombosis within the popliteal vein (Rumack et al. 2011)