Sonography: a sensitive and specific method for detecting trochlear cartilage pathologies

Area of Science:

• Orthopedics
• Radiology
• Medical Imaging

Background:

• Magnetic Resonance Imaging (MRI) is standard for articular cartilage evaluation.
• MRI has limitations, including contraindications for some patients.
• Ultrasound (US) may serve as an initial imaging modality for cartilage assessment.

Purpose of the Study:

• To evaluate the efficacy of ultrasonography in detecting low-grade trochlear cartilage lesions.
• To determine the sensitivity and specificity of ultrasound for grading trochlear cartilage pathology.

Main Methods:

• Prospective study of 48 arthroscopic surgery candidates (July 2018-July 2019).
• Pre-operative ultrasound assessment of trochlear cartilage by an experienced radiologist using a 13-MHz probe.
• Comparison of ultrasound findings with arthroscopic examination by an orthopedic knee surgeon.

Main Results:

• Ultrasound achieved 100% sensitivity and 88.2% specificity in grading trochlear cartilage lesions.
• Study included 48 patients (mean age 33.2 years, 81% male).
• Ultrasound correctly identified normal cartilage in 30 cases versus 34 by arthroscopy.

Conclusions:

• Sonography is a cost-effective and accessible diagnostic tool for early detection of trochlear cartilage pathologies.
• Ultrasound exhibits high sensitivity and specificity for identifying these lesions.
• It can be instrumental in outpatient diagnostic workups for anterior knee pain.