University of Oulu

Nevalainen, M.T., Pitkänen, M.-M. and Saarakkala, S. (2022), Diagnostic Performance of Ultrasonography for Evaluation of Osteoarthritis of Ankle Joint: Comparison With Radiography, Cone-Beam CT, and Symptoms. J Ultrasound Med, 41: 1139-1146.

Diagnostic performance of ultrasonography for evaluation of osteoarthritis of ankle joint : comparison with radiography, cone-beam CT, and symptoms

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Author: Nevalainen, Mika T.1,2,3; Pitkänen, Milla-Maaria1; Saarakkala, Simo1,2,3
Organizations: 1Department of Diagnostic Radiology, Oulu University Hospital, Oulu
2Medical Research Center Oulu, University of Oulu, Oulu
3Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.4 MB)
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Language: English
Published: John Wiley & Sons, 2022
Publish Date: 2022-09-09


Objectives: To determine the diagnostic performance of ultrasonography (US) for evaluation of the ankle joint osteoarthritic (OA) changes. Cone-beam computed tomography (CT) was used as the gold standard and US performance was compared with conventional radiography (CR). As a secondary aim, associations between the imaging findings and ankle symptoms were assessed.

Methods: US was performed to 51 patients with ankle OA. Every patient had prior ankle CR and underwent cone-beam CT during the same day as US examination. On US, effusion/synovitis, osteophytes, talar cartilage damage, and tenosynovitis were evaluated. Comparison to respective imaging findings on CR and cone-beam CT was then performed. Single radiologist blinded to other modalities assessed all the imaging studies. Symptoms questionnaire, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), was available for 48 patients.

Results: US detected effusion/synovitis of the talocrural joint with 45% sensitivity and 90% specificity. For the detection of anterior talocrural osteophytes, US sensitivity was 78% and specificity 79%. For the medial talocrural osteophytes, they were 39 and 83%, and for the lateral talocrural osteophytes 54 and 100%, respectively. Considering cartilage damage of the talus, US yielded a low sensitivity of 18% and high specificity of 97%. Overall, the performance of US was only moderate and comparable to CR. The imaging findings showed only weak associations with ankle symptoms.

Conclusions: The ability of US to detect ankle OA is only moderate. Interestingly, performance of CR also remained moderate. The associations between imaging findings and WOMAC score seem to be weak in ankle OA.

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Series: Journal of ultrasound in medicine
ISSN: 0278-4297
ISSN-E: 1550-9613
ISSN-L: 0278-4297
Volume: 41
Issue: 5
Pages: 1139 - 1146
DOI: 10.1002/jum.15803
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Funding: Open access funding enabled and organized by Projekt DEAL.
Copyright information: © 2021 The Authors. Journal of Ultrasound in Medicine published by Wiley Periodicals LLC on behalf of American Institute of Ultrasound in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.