Ultrasound diagnosis of cystic formations of the knee joint

O.A. Burianov, Yu.V. Klapchuk, O.L. Borodai

Abstract


Ultrasound diagnosis of the knee is widely implemented in the practice of both domestic and foreign medicine. In 1972, D.G. McDonald, G.R. Leopold, using the method of ultrasound in arthrology, reported the possibility of sonography application for the diagnosis of cysts. I.M. Danilova described three periods of sonographic organization of popliteal cysts: I — early structural changes, II — progressing structural changes and III — the ultimate structural organization. In the area of the knee joint, the following cystic formations (CF) are observed: prepatellar bursitis, infrapatellar deep and superficial bursitis, pes anserine bursitis, meniscal cysts, intra-articular CF, for the diagnosis of which anterior and lateral approaches of examination are used. The aim of the study was to determine, based on analysis of ultrasound examination, at which stages of the disease course the CF are most common and to determine the degree of diagnostic value of ultrasonography in patients with CF of the knee associated with intra-articular pathology by comparing ultrasound examination of the knee lesions with arthroscopy. During the period of 2014–2015, in the trauma unit of the Military Medical Center of Northern region, the sonography of the knee joint was performed in 46 patients with knee pathology, including cystic formations. The average age of patients was 36.8 ± 8.3 years (from 18 to 76 years). Ultrasound was performed on the ultrasound devices ULTIMAPA L5-10/40E
and VOLUSON with the frequency of linear transducer of 5.5–7.5 MHz/40 mm/128 el.) manufactured by Radmir, with Doppler scanning. After sonography, 38 patients underwent diagnostic and therapeutic arthroscopy of the knee joint, making it possible to compare the results of sonography and arthroscopy. To assess the effectiveness of diagnostic tests, the following parameters were calculated: sensitivity, specificity, overall value of the method (accuracy), predictability of positive and negative results. After the study, it was found that Baker’s cyst were detected in 31 patients, pes anserine bursitis — in 4, meniscal cyst — in 2, prepatellar bursitis — in 4, infrapatellar bursitis — in 3, intraarticular ganglial СF — in 2 cases. During the examination of patients with CF of the knee joint, it became known that the majority of examinees had the second and third stages of the disease, which suggests the conservative treatment is ineffective given the structural changes that have taken place in the CF. Summarizing the results of sonography, it should de noted the high sensitivity and accuracy with the predictability of outcomes in relation to cystic formations and extra-articular ligaments. Also, this method of survey shows a very low sensitivity and specificity in terms of the cartilage damage and is not very informative in cruciate ligament injuries, for which the method of choice is magnetic resonance imaging and spiral computed arthrography. Thanks to the new highly informative ultrasound devices with broadband, high-frequency ultrasonic sensors and considering non-invasiveness, absence of radiation exposure, cost effectiveness, availability and no contraindications to sonography, we can recommend this method as obligatory in patients with suspected injuries and diseases of the knee joint, especially in the presence of cystic formations.


Keywords


Ultrasound diagnosis of the knee is widely implemented in the practice of both domestic and foreign medicine. In 1972, D.G. McDonald, G.R. Leopold, using the method of ultrasound in arthrology, reported the possibility of sonography application for the di

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DOI: https://doi.org/10.22141/1608-1706.2.18.2017.102562

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