Ultrasound and x-ray examination of the knee in patients with rheumatoid arthritis and osteoarthritis: correlation between imaging data and pain severity

Objective: to assess the correlations between pain severity and changes in intra-articular structures according to ultrasound and x-ray examination of the knee in patients with rheumatoid arthritis and osteoarthritis.
Material and methods: a total of 60 patients with rheumatoid arthritis and osteoarthritis (15 males and 45 females aged 22–80 years) underwent standard clinical and laboratory evaluation, ultrasound and x-ray examination of both knees (n = 120) within a week after including to the study. Patients were divided into two groups according the diagnosis: the first group – patients with rheumatoid arthritis (n = 27) and the second group – patients with osteoarthritis (n = 33). Pain severity assessed by the visual analogue scale. Synovial vascularity was assessed by using of color Doppler imaging according to the 4-grade scale.
Results: there were no significant differences between the groups of patients in terms of disease duration and pain severity, including in functional tests. A strong correlation was found between the pain severity and degree of synovial vascularity (r = 0.805, P < 0.001) and a weak correlation between the pain severity and synovial hypertrophy (r = 0.473, P < 0.001) during ultrasound examination. A moderate correlation was found between the pain severity and size of marginal osteophytes (r = 0.673, P < 0.001) and a very weak correlation between the pain severity and joint space width (r = 0.395, P < 0.001) during x-ray examination. The synovial hypervascularity in color Doppler imaging (grade 2 and 3) associated with pain severity is more typical for rheumatoid arthritis than for osteoarthritis (P = 0.001).
Conclusion: the most significant correlations between the severity of the pain syndrome, on the one hand, and ultrasound and x-ray signs, on the other hand, were determined for the synovial vascularity degree during ultrasound examination and the size of the marginal osteophytes during x-ray examination.

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