{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:09:56Z","timestamp":1791378596761,"version":"4.3.2"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T00:00:00Z","timestamp":1629072000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T00:00:00Z","timestamp":1629072000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001807","name":"S\u00e3o Paulo Research Foundation","doi-asserted-by":"crossref","award":["#2017\/12943-8"],"award-info":[{"award-number":["#2017\/12943-8"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Worldwide, knee osteoarthritis (KOA) accounts for 2.2% of total years lived with disability. There is a low correlation between joint tissue damage and pain intensity. Periarticular structures may be involved and cannot be identified in X-rays. To describe the main ultrasonography (USG) changes in symptomatic patients with primary KOA; to correlate the number of USG findings with KOA severity assessed by Kellgren and Lawrence (K&amp;L) radiological scores, with pain intensity measured by a visual analogue scale (VAS) and with functioning scores assessed with the Timed up and go test (TUG) and Western Ontario and McMaster Universities (WOMAC) questionnaire. 100 patients with primary symptomatic KOA were assessed with X-ray and USG. Quantitative and qualitative analyses were evaluated in a systematic manner. The most frequent findings were joint effusion, pes anserinus bursitis, quadriceps tendon enthesopathy, popliteal cyst, iliotibial band tendinitis and patellar tendinitis. Pearson\u2019s correlation analysis demonstrated a significant moderate positive association between VAS scores and the number of USG findings (r\u2009=\u20090.36; p\u2009&lt;\u20090.0001). The number of USG findings was different between K&amp;L grades I and III (p\u2009=\u20090.041), I and IV (p\u2009&lt;\u20090.001), and II and IV (p\u2009=\u20090.001, analysis of variance with Bonferroni correction). There was significant association between number of USG findings and TUG (r\u2009=\u20090.18; p\u2009=\u20090.014) and WOMAC scores for pain (r\u2009=\u20090.16; p\u2009&lt;\u20090.029) and physical function domains (r\u2009=\u20090.16; p\u2009&lt;\u20090.028). The most frequent USG finding was joint effusion. Periarticular structures should be explored as potential sources of pain and disability.<\/jats:p>","DOI":"10.1038\/s41598-021-95419-3","type":"journal-article","created":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T10:03:52Z","timestamp":1629108232000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Ultrasonography findings in knee osteoarthritis: a prospective observational cross-sectional study of 100 patients"],"prefix":"10.1038","volume":"11","author":[{"given":"Claudia Andreia Rabay Pimentel","family":"Abicalaf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leticia Naomi","family":"Nakada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe Ricardo Aquino","family":"dos Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Akiho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Artur Cesar Aquino","family":"dos Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Imamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linamara Rizzo","family":"Battistella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,16]]},"reference":[{"issue":"10267","key":"95419_CR1","doi-asserted-by":"publisher","first-page":"2006","DOI":"10.1016\/S0140-6736(20)32340-0","volume":"396","author":"A Cieza","year":"2020","unstructured":"Cieza, A. et al. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019. Lancet 396(10267), 2006\u20132017 (2020).","journal-title":"Lancet"},{"issue":"7","key":"95419_CR2","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.1136\/annrheumdis-2013-204763","volume":"73","author":"M Cross","year":"2014","unstructured":"Cross, M. et al. The global burden of hip and knee osteoarthritis: Estimates from the global burden of disease 2010 study. Ann. Rheum. Dis. 73(7), 1323\u20131330 (2014).","journal-title":"Ann. Rheum. Dis."},{"key":"95419_CR3","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1111\/j.1749-6632.2009.05240.x","volume":"1192","author":"MB Goldring","year":"2010","unstructured":"Goldring, M. B. & Goldring, S. R. Articular cartilage and subchondral bone in the pathogenesis of osteoarthritis. Ann. N. Y. Acad. Sci. 1192, 230\u2013237 (2010).","journal-title":"Ann. N. Y. Acad. Sci."},{"issue":"2","key":"95419_CR4","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1177\/1759720X12467868","volume":"5","author":"J Sokolove","year":"2013","unstructured":"Sokolove, J. & Lepus, C. M. Role of inflammation in the pathogenesis of osteoarthritis: Latest findings and interpretations. Ther. Adv. Musculoskelet. Dis. 5(2), 77\u201394 (2013).","journal-title":"Ther. Adv. Musculoskelet. Dis."},{"issue":"12","key":"95419_CR5","first-page":"1943","volume":"19","author":"MA Davis","year":"1992","unstructured":"Davis, M. A., Ettinger, W. H., Neuhaus, J. M., Barclay, J. D. & Segal, M. R. Correlates of knee pain among US adults with and without radiographic knee osteoarthritis. J. Rheumatol. 19(12), 1943\u20131949 (1992).","journal-title":"J. Rheumatol."},{"issue":"6","key":"95419_CR6","first-page":"1513","volume":"27","author":"MT Hannan","year":"2000","unstructured":"Hannan, M. T., Felson, D. T. & Pincus, T. Analysis of the discordance between radiographic changes and knee pain in osteoarthritis of the knee. J. Rheumatol. 27(6), 1513\u20131517 (2000).","journal-title":"J. Rheumatol."},{"key":"95419_CR7","doi-asserted-by":"publisher","first-page":"b2844","DOI":"10.1136\/bmj.b2844","volume":"339","author":"T Neogi","year":"2009","unstructured":"Neogi, T. et al. Association between radiographic features of knee osteoarthritis and pain: results from two cohort studies. BMJ 339, b2844 (2009).","journal-title":"BMJ"},{"key":"95419_CR8","doi-asserted-by":"publisher","first-page":"780","DOI":"10.2106\/00004623-200704000-00012","volume":"89","author":"S Kurtz","year":"2007","unstructured":"Kurtz, S., Ong, K., Lau, E., Mowat, F. & Halpern, M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J. Bone Jt. Surg. Am. 89, 780\u2013785 (2007).","journal-title":"J. Bone Jt. Surg. Am."},{"issue":"6","key":"95419_CR9","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1016\/j.joca.2005.12.012","volume":"14","author":"EM Mendieta","year":"2006","unstructured":"Mendieta, E. M., Ib\u00e1\u00f1ez, T. C., Jaeger, J. U., Hern\u00e1n, G. B. & Mola, E. M. Clinical and ultrasonographic findings related to knee pain in osteoarthritis. Osteoarthr. Cartil. 14(6), 540\u2013544 (2006).","journal-title":"Osteoarthr. Cartil."},{"issue":"8","key":"95419_CR10","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1007\/s10067-011-1701-x","volume":"30","author":"BB Mermerci","year":"2011","unstructured":"Mermerci, B. B. et al. Clinic and ultrasound findings related to pain in patients with knee osteoarthritis. Clin. Rheumatol. 30(8), 1055\u20131062 (2011).","journal-title":"Clin. Rheumatol."},{"issue":"9","key":"95419_CR11","doi-asserted-by":"publisher","first-page":"1625","DOI":"10.1093\/rheumatology\/keu030","volume":"53","author":"K Bevers","year":"2014","unstructured":"Bevers, K., Bijlsma, J. W., Vriezekolk, J. E., van den Ende, C. H. & den Broeder, A. A. Ultrasonographic features in symptomatic osteoarthritis of the knee and relation with pain. Rheumatology (Oxford) 53(9), 1625\u20131629 (2014).","journal-title":"Rheumatology (Oxford)"},{"issue":"10","key":"95419_CR12","doi-asserted-by":"publisher","first-page":"1627","DOI":"10.1016\/j.joca.2014.05.025","volume":"22","author":"M Hall","year":"2014","unstructured":"Hall, M. et al. Synovial pathology detected on ultrasound correlates with the severity of radiographic knee osteoarthritis more than with symptoms. Osteoarthr. Cartil. 22(10), 1627\u20131633 (2014).","journal-title":"Osteoarthr. Cartil."},{"issue":"5","key":"95419_CR13","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1111\/1756-185X.12190","volume":"17","author":"F\u00dc Malas","year":"2014","unstructured":"Malas, F. \u00dc., Kara, M., Kaymak, B., Ak\u0131nc\u0131, A. & \u00d6z\u00e7akar, L. Ultrasonographic evaluation in symptomatic knee osteoarthritis: Clinical and radiological correlation. Int. J. Rheum. Dis. 17(5), 536\u2013540 (2014).","journal-title":"Int. J. Rheum. Dis."},{"issue":"1","key":"95419_CR14","doi-asserted-by":"publisher","first-page":"128","DOI":"10.3109\/14397595.2014.931909","volume":"25","author":"H Toktas","year":"2015","unstructured":"Toktas, H., Dundar, U., Adar, S., Solak, O. & Ulasli, A. M. Ultrasonographic assessment of pes anserinus tendon and pes anserinus tendinitis bursitis syndrome in patients with knee osteoarthritis. Mod. Rheumatol. 25(1), 128\u2013133 (2015).","journal-title":"Mod. Rheumatol."},{"issue":"3","key":"95419_CR15","doi-asserted-by":"publisher","first-page":"205","DOI":"10.5152\/eurjrheum.2017.160097","volume":"4","author":"SM Abd El Monaem","year":"2017","unstructured":"Abd El Monaem, S. M., Hashaad, N. I. & Ibrahim, N. H. Correlations between ultrasonographic findings, clinical scores, and depression in patients with knee osteoarthritis. Eur. J. Rheumatol. 4(3), 205\u2013209 (2017).","journal-title":"Eur. J. Rheumatol."},{"issue":"8","key":"95419_CR16","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1002\/art.1780290816","volume":"29","author":"R Altman","year":"1986","unstructured":"Altman, R. et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 29(8), 1039\u20131049 (1986).","journal-title":"Arthritis Rheum."},{"issue":"7889","key":"95419_CR17","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1016\/S0140-6736(74)90884-8","volume":"2","author":"EC Huskisson","year":"1974","unstructured":"Huskisson, E. C. Measurement of pain. Lancet 2(7889), 1127\u20131131 (1974).","journal-title":"Lancet"},{"issue":"5","key":"95419_CR18","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1002\/1529-0131(200110)45:5<453::AID-ART365>3.0.CO;2-W","volume":"45","author":"S McConnell","year":"2001","unstructured":"McConnell, S., Kolopack, P. & Davis, A. M. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): A review of its utility and measurement properties. Arthritis Rheum. 45(5), 453\u2013461 (2001).","journal-title":"Arthritis Rheum."},{"issue":"2","key":"95419_CR19","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1111\/j.1532-5415.1991.tb01616.x","volume":"39","author":"D Podsiadlo","year":"1991","unstructured":"Podsiadlo, D. & Richardson, S. The timed \u201cUp & Go\u201d: A test of basic functional mobility for frail elderly persons. J. Am. Geriatr. Soc. 39(2), 142\u2013148 (1991).","journal-title":"J. Am. Geriatr. Soc."},{"issue":"4","key":"95419_CR20","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1136\/ard.16.4.494","volume":"16","author":"JH Kellgren","year":"1957","unstructured":"Kellgren, J. H. & Lawrence, J. S. Radiological assessment of osteo-arthrosis. Ann. Rheum. Dis. 16(4), 494\u2013502 (1957).","journal-title":"Ann. Rheum. Dis."},{"key":"95419_CR21","volume-title":"Introductory Biostatistics","author":"CT Le","year":"2016","unstructured":"Le, C. T. & Eberly, L. E. Introductory Biostatistics (Wiley, 2016)."},{"key":"95419_CR22","volume-title":"Principles of Biostatistics","author":"M Pagano","year":"2018","unstructured":"Pagano, M. & Gauvreau, K. Principles of Biostatistics (CRC Press, 2018)."},{"issue":"1","key":"95419_CR23","first-page":"75","volume":"30","author":"P Monteforte","year":"2008","unstructured":"Monteforte, P., Sessarego, P. & Rovetta, G. Sonographic assessment of soft tissue alterations in osteoarthritis of the knee. G. Ital. Med. Lav. Ergon. 30(1), 75\u201377 (2008).","journal-title":"G. Ital. Med. Lav. Ergon."},{"issue":"7","key":"95419_CR24","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1016\/j.joca.2005.02.008","volume":"13","author":"E Naredo","year":"2005","unstructured":"Naredo, E. et al. Ultrasonographic findings in knee osteoarthritis: A comparative study with clinical and radiographic assessment. Osteoarthr. Cartil. 13(7), 568\u2013574 (2005).","journal-title":"Osteoarthr. Cartil."},{"issue":"5","key":"95419_CR25","first-page":"673","volume":"30","author":"K Bevers","year":"2012","unstructured":"Bevers, K. et al. Ultrasonographic analysis in knee osteoarthritis: Evaluation of inter-observer reliability. Clin. Exp. Rheumatol. 30(5), 673\u2013678 (2012).","journal-title":"Clin. Exp. Rheumatol."},{"issue":"11","key":"95419_CR26","doi-asserted-by":"publisher","first-page":"2013","DOI":"10.1093\/rheumatology\/kes161","volume":"51","author":"A Iagnocco","year":"2012","unstructured":"Iagnocco, A. et al. The interobserver reliability of ultrasound in knee osteoarthritis. Rheumatology (Oxford) 51(11), 2013\u20132019 (2012).","journal-title":"Rheumatology (Oxford)"},{"issue":"2","key":"95419_CR27","doi-asserted-by":"publisher","first-page":"373","DOI":"10.2214\/ajr.176.2.1760373","volume":"176","author":"EE Ward","year":"2001","unstructured":"Ward, E. E., Jacobson, J. A., Fessell, D. P., Hayes, C. W. & van Holsbeeck, M. Sonographic detection of Baker\u2019s cysts: Comparison with MR imaging. Am. J. Roentgenol. 176(2), 373\u2013380 (2001).","journal-title":"Am. J. Roentgenol."},{"issue":"5","key":"95419_CR28","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1016\/j.semarthrit.2015.10.004","volume":"45","author":"N Maricar","year":"2016","unstructured":"Maricar, N., Callaghan, M. J., Parkes, M. J., Felson, D. T. & O\u2019Neill, T. W. Clinical assessment of effusion in knee osteoarthritis\u2014A systematic review. Semin. Arthritis Rheum. 45(5), 556\u2013563 (2016).","journal-title":"Semin. Arthritis Rheum."},{"issue":"11","key":"95419_CR29","doi-asserted-by":"publisher","first-page":"2000","DOI":"10.1093\/rheumatology\/kev224","volume":"54","author":"K Bevers","year":"2015","unstructured":"Bevers, K., Vriezekolk, J. E., Bijlsma, J. W., van den Ende, C. H. & den Broeder, A. A. Ultrasonographic predictors for clinical and radiological progression in knee osteoarthritis after 2 years of follow-up. Rheumatology (Oxford) 54(11), 2000\u20132003 (2015).","journal-title":"Rheumatology (Oxford)"},{"issue":"7","key":"95419_CR30","first-page":"518","volume":"62","author":"C Resende","year":"2003","unstructured":"Resende, C., De Miguel, E. & Mart\u00edn-Mola, E. The usefulness of 30\u00b0 knee flexion in the assessment of suprapatellar bursa swelling by ultrasound. Ann. Rheum. Dis. 62(7), 518 (2003).","journal-title":"Ann. Rheum. Dis."},{"issue":"12","key":"95419_CR31","doi-asserted-by":"publisher","first-page":"2260","DOI":"10.1002\/art.1780401223","volume":"40","author":"YC Pai","year":"1997","unstructured":"Pai, Y. C., Rymer, W. Z., Chang, R. W. & Sharma, L. Effect of age and osteoarthritis on knee proprioception. Arthritis Rheum. 40(12), 2260\u20132265 (1997).","journal-title":"Arthritis Rheum."},{"issue":"3","key":"95419_CR32","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1007\/s40477-015-0168-z","volume":"18","author":"F Draghi","year":"2015","unstructured":"Draghi, F., Corti, R., Urciuoli, L., Alessandrino, F. & Rotondo, A. Knee bursitis: A sonographic evaluation. J. Ultrasound. 18(3), 251\u2013257 (2015).","journal-title":"J. Ultrasound."},{"issue":"10","key":"95419_CR33","doi-asserted-by":"publisher","first-page":"2836","DOI":"10.1002\/art.11254","volume":"48","author":"CL Hill","year":"2003","unstructured":"Hill, C. L. et al. Periarticular lesions detected on magnetic resonance imaging: Prevalence in knees with and without symptoms. Arthritis Rheum. 48(10), 2836\u20132844 (2003).","journal-title":"Arthritis Rheum."},{"issue":"2","key":"95419_CR34","first-page":"49","volume":"5","author":"O Niwa","year":"2019","unstructured":"Niwa, O., Kato, S. & Terada, N. Correlation between ultrasonographic findings and symptoms of knee osteoarthritis. Fujita Med. J. 5(2), 49\u201352 (2019).","journal-title":"Fujita Med. J."},{"key":"95419_CR35","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1007\/s11547-019-01013-z","volume":"124","author":"T Okano","year":"2019","unstructured":"Okano, T., Mamoto, K., Di Carlo, M. & Salaffi, F. Clinical utility and potential of ultrasound in osteoarthritis. Radiol. Med. 124, 1101\u20131111 (2019).","journal-title":"Radiol. Med."},{"issue":"4","key":"95419_CR36","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1007\/s10067-015-2990-2","volume":"35","author":"AA Razek","year":"2016","unstructured":"Razek, A. A. & El-Basyouni, S. R. Ultrasound of knee osteoarthritis: Interobserver agreement and correlation with Western Ontario and McMaster Universities Osteoarthritis. Clin. Rheumatol. 35(4), 997\u20131001 (2016).","journal-title":"Clin. Rheumatol."},{"issue":"4","key":"95419_CR37","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1136\/ard.2008.099564","volume":"69","author":"PG Conaghan","year":"2010","unstructured":"Conaghan, P. G. et al. Clinical and ultrasonographic predictors of joint replacement for knee osteoarthritis: Results from a large, 3-year, prospective EULAR study. Ann. Rheum. Dis. 69(4), 644\u2013647 (2010).","journal-title":"Ann. Rheum. Dis."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-95419-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-95419-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-95419-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T12:05:02Z","timestamp":1699358702000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-95419-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,16]]},"references-count":37,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["95419"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-95419-3","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,16]]},"assertion":[{"value":"30 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"16589"}}