ultrasound findings of the knee joint at khartoum teaching hospital ...

Ozean Journal of Applied Sciences 5(4), 2012
effects of U/S date as far back as the early 1920’s and, since then, extensive research describing its
mechanisms and bioeffects has been published.Using U/Sas a clinical investigative tool started in 1950’s.
However, its application in imaging of MUS remained underutilized till 1980’s(Mamix et al., 1995).
Soft tissue pathology of the knee represents one of the more common, yet perplexing, musculoskeletal
disorders presenting at Khartoum Teaching Hospital. Knee pain and related symptoms may come as a
result of damage to one or more of the soft tissue structures that stabilize and cushion the knee joint,
including the ligaments, muscles, tendons, and menisci. Khartoum Teaching Hospital records of
2011/2012 show that averages of 500 patients with knee joint disorders were seen in orthopaedic and
rheumatology outpatient clinics out of a total of 6000 patients annually.
In a country with a population of 40 million people, it contributes significantly to the burden of disease.
The only mode of examination for these patients has been X-rays of the knee and this meant that little
information was got about the soft tissue component of the knee. U/S of the knee joint has the advantage
over Magnetic resonance imaging (MRI) in that it is cheaper, convenient and easier to use, is dynamic
and has no contra-indications to its use(Iagnocco, 2010).
U/S involves no radiation and can obtain views in multiple planes. It can also visualize soft tissue
structures like the menisci and cartilage and can yield a lot more information on the bursae, tendons,
muscles, ligaments menisci and joint space pathologies(Grassi, Lamanna, & Cervini, 1999).
METHODOLOGY
Selection and description of participants
Thiscross sectional descriptive study was performed in the period of May 2011 to May 2012. A total of
100consecutive patientsreferred to the Radiology department with knee joint symptoms were recruited.
After the nature of the exam was fully explained, informed consent was obtained from both the
consecutively enrolled outpatient and the U/S department. Also prior to samples scanning, a formal
approval was obtained from Ethics and Scientific Committee of Khartoum Teaching Hospital, Khartoum-
Sudan.
Patient characteristics; including socio-demographic data, clinical history and physical examination
findings were recorded. Patients who had no clinical evidence of knee joint pain, knee joint involvement
and other forms of inflammatory diseases were not included in this study.
Technical information identify
Sonography of the knee joints was done using General Electric (GE) medical system, logic5 expert U/S
machine (Sony Corporation, Japan). The applied U/S transducer was a linear probe of a frequency 7.5-10
MHz, made by the Yokogawa medical system, Ltd. 7-127 Asahigaoka 4-chome Hino-shi Tokyo, Japan.
Model 2302650 with serial number of 1028924YM7 and manufactured date of April 2005. Printing
facility issued through U/S digital graphic printer, 100 V; 1.5 A; and 50/60 Hz. Made by Sony
Corporation- Japan, with serial number of 3-619-GBI-01.
U/S images were recorded on a hard copy and the films were independently reviewed by two radiologist
and results combined therefore. However, there was no statistically significant interobserver variation.
The knee joint was examined by the Technical Guidelinesofthe European Society of Musculoskeletal
Radiology (ESSR)(Ian et al., 2012),comprehensively in different scanning approaches: 1. Anterior knee
approach to assess the quadriceps tendon, supra-patellar and para-patellar recesses, femoral trochlea,
patellar retinacula and patellar medial articular facet, patellar tendon. 2. Medial knee approach used to
study medial collateral ligament and pes anserinus tendons.3. Lateral knee approach used to evaluate the
iliotibial band and lateral collateral ligament. 4. Posterior knee approach used to check the medial
tendons, semimembranosus- gastrocnemius bursa, popliteal neurovascular bundle and intercondylar fossa,
posterolateral corner and biceps femoris and peroneal nerve.
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