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Peer-reviewedCC BY-NC-NDOsteoarthritis and Cartilage Open

Ultrasonographic imaging for early-stage knee osteoarthritis: Radiographic and clinical associations in a cross-sectional single-center study

  • K. Kauppinen1
  • A. Uusimaa2
  • E. Liukkonen3
  • J. Määttä4
  • S. Saarakkala4
  • M.T. Nevalainen4
4 affiliations
  1. 1Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, POB 5000, FI-90014 Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 50, 90029 Oulu, Finland; Corresponding author. Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, POB 5000, FI-90014, Oulu, Finland.
  2. 2Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, POB 5000, FI-90014 Oulu, Finland
  3. 3Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 50, 90029 Oulu, Finland
  4. 4Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, POB 5000, FI-90014 Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 50, 90029 Oulu, Finland
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Abstract

Objective: To evaluate whether ultrasonography (US) detects early-stage knee osteoarthritis (OA) more effectively than conventional radiography (CR) in a population representing primary and occupational healthcare, and to assess associations between imaging findings and symptoms. Design: In this cross-sectional study, 315 subjects (60% women; mean age 49 years, range 21–63 years) with knee symptoms underwent knee US and CR, resulting in assessment of 345 knees. Ultrasonographic evaluation included effusion, synovial hypertrophy, osteophytes, femoral cartilage damage, meniscal pathology, and protrusion, from which a composite US sum score was constructed. Radiographic severity was graded using the Kellgren-Lawrence (KL) scale (grade 0, n = 128; grade 1, n = 90; grade 2, n = 78; grade 3, n = 38; grade 4, n = 11). WOMAC questionnaires were completed prior to imaging. Statistical analyses included Kruskal–Wallis and Mann–Whitney tests, univariate analyses, and Pearson correlation coefficients. Results: US detected more osteophytes than CR, particularly at the femoral margins, while tibial osteophyte detection was comparable between modalities. US identified more femoral cartilage damage than CR-detected joint-space narrowing. Meniscal protrusion was associated with radiographic joint-space narrowing and KL grade (p < 0.001). Effusion size and synovial hypertrophy increased with higher KL grades (p < 0.001). The US sum score correlated with KL grade (r = 0.73, p < 0.001). Both the US sum score and KL grade showed modest associations with WOMAC scores. Conclusions: US detects more structural abnormalities than CR in early-stage knee OA. While ultrasonographic findings correlate with radiographic severity, their associations with clinical symptoms remain limited, supporting US as a complementary tool for structural assessment in knee OA.

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Cite

BibTeXRIS
BibTeX
@article{kauppinen2026ultrasonographic,
  title = {{Ultrasonographic imaging for early-stage knee osteoarthritis: Radiographic and clinical associations in a cross-sectional single-center study}},
  author = {K. Kauppinen and A. Uusimaa and E. Liukkonen and J. Määttä and S. Saarakkala and M.T. Nevalainen},
  journal = {Osteoarthritis and Cartilage Open},
  year = {2026},
  month = oct,
  doi = {10.1016/j.ocarto.2026.100883},
  url = {https://doi.org/10.1016/j.ocarto.2026.100883},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Ultrasonographic imaging for early-stage knee osteoarthritis: Radiographic and clinical associations in a cross-sectional single-center study
AU  - K. Kauppinen
AU  - A. Uusimaa
AU  - E. Liukkonen
AU  - J. Määttä
AU  - S. Saarakkala
AU  - M.T. Nevalainen
PY  - 2026
DA  - 2026/10/06
JO  - Osteoarthritis and Cartilage Open
DO  - 10.1016/j.ocarto.2026.100883
UR  - https://doi.org/10.1016/j.ocarto.2026.100883
AB  - Objective: To evaluate whether ultrasonography (US) detects early-stage knee osteoarthritis (OA) more effectively than conventional radiography (CR) in a population representing primary and occupational healthcare, and to assess associations between imaging findings and symptoms. Design: In this cross-sectional study, 315 subjects (60% women; mean age 49 years, range 21–63 years) with knee symptoms underwent knee US and CR, resulting in assessment of 345 knees. Ultrasonographic evaluation included effusion, synovial hypertrophy, osteophytes, femoral cartilage damage, meniscal pathology, and protrusion, from which a composite US sum score was constructed. Radiographic severity was graded using the Kellgren-Lawrence (KL) scale (grade 0, n = 128; grade 1, n = 90; grade 2, n = 78; grade 3, n = 38; grade 4, n = 11). WOMAC questionnaires were completed prior to imaging. Statistical analyses included Kruskal–Wallis and Mann–Whitney tests, univariate analyses, and Pearson correlation coefficients. Results: US detected more osteophytes than CR, particularly at the femoral margins, while tibial osteophyte detection was comparable between modalities. US identified more femoral cartilage damage than CR-detected joint-space narrowing. Meniscal protrusion was associated with radiographic joint-space narrowing and KL grade (p < 0.001). Effusion size and synovial hypertrophy increased with higher KL grades (p < 0.001). The US sum score correlated with KL grade (r = 0.73, p < 0.001). Both the US sum score and KL grade showed modest associations with WOMAC scores. Conclusions: US detects more structural abnormalities than CR in early-stage knee OA. While ultrasonographic findings correlate with radiographic severity, their associations with clinical symptoms remain limited, supporting US as a complementary tool for structural assessment in knee OA.
SN  - 2665-9131
ER  -