TY - JOUR T1 - EULAR report on the use of ultrasonography in painful knee osteoarthritis. Part 1: Prevalence of inflammation in osteoarthritis JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 1703 LP - 1709 DO - 10.1136/ard.2005.037994 VL - 64 IS - 12 AU - M A D’Agostino AU - P Conaghan AU - M Le Bars AU - G Baron AU - W Grassi AU - E Martin-Mola AU - R Wakefield AU - J-L Brasseur AU - A So AU - M Backhaus AU - M Malaise AU - G Burmester AU - N Schmidely AU - P Ravaud AU - M Dougados AU - P Emery Y1 - 2005/12/01 UR - http://ard.bmj.com/content/64/12/1703.abstract N2 - Objectives: To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or joint effusion at ultrasonography (US); and to evaluate the correlation between synovitis, effusion, and clinical parameters.Methods: A cross sectional, multicentre, European study was conducted under the umbrella of EULAR-ESCISIT. Subjects had primary chronic knee OA (ACR criteria) with pain during physical activity ⩾30 mm for at least 48 hours. Clinical parameters were collected by a rheumatologist and an US examination of the painful knee was performed by a radiologist or rheumatologist within 72 hours of the clinical examination. Ultrasonographic synovitis was defined as synovial thickness ⩾4 mm and diffuse or nodular appearance, and a joint effusion was defined as effusion depth ⩾4 mm.Results: 600 patients with painful knee OA were analysed. At US 16 (2.7%) had synovitis alone, 85 (14.2%) had both synovitis and effusion, 177 (29.5%) had joint effusion alone, and 322 (53.7%) had no inflammation according to the definitions employed. Multivariate analysis showed that inflammation seen by US correlated statistically with advanced radiographic disease (Kellgren-Lawrence grade ⩾3; odds ratio (OR) = 2.20 and 1.91 for synovitis and joint effusion, respectively), and with clinical signs and symptoms suggestive of an inflammatory “flare”, such as joint effusion on clinical examination (OR = 1.97 and 2.70 for synovitis and joint effusion, respectively) or sudden aggravation of knee pain (OR = 1.77 for joint effusion).Conclusion: US can detect synovial inflammation and effusion in painful knee OA, which correlate significantly with knee synovitis, effusion, and clinical parameters suggestive of an inflammatory “flare”. ER -