Milken Institute School of Public Health Poster Presentations (Marvin Center & Video)

Title

The association between musculoskeletal ultrasound measures and knee arthritis status in older Veterans

Poster Number

72

Document Type

Poster

Status

Staff

Abstract Category

Exercise and Nutrition Sciences

Keywords

arthritis, knee, ultrasound, aging, Veterans

Publication Date

4-2017

Abstract

Background: Radiography is routinely used to assess knee osteoarthritis (OA), a degenerative condition involving articular cartilage and skeletal muscle. However, OA radiographic features do not consistently agree with patient-reported quality of life and other imaging modalities may offer better clinical utility. Diagnostic musculoskeletal ultrasound (MUS) can characterize muscle tissue structure and composition in knee OA. However, less is known about the association between MUS findings and patient symptomology. The purpose of this study is to determine whether quantitative MUS measures of skeletal muscle morphology and morphometry are associated with clinical markers of knee OA.

Methods: Male Veterans with knee OA (n=36; age=62.2 ±5.7 yr; BMI=31.2 ±6.5) participated in the study. Self-reported symptoms and physical function were evaluated using the Knee injury and Osteoarthritis Outcome Score (KOOS). Knee OA asymmetry was determined by the Kellgren–Lawrence grade and self-reported pain. B-mode quantitative MUS with a 13-6 MHz linear array transducer were used to obtain tissue echogenicity and muscle thickness values. The primary scanning site was the rectus femoris of the participants more and less involved leg. Additional sites included the trapezius, deltoid, pectoralis major, and brachioradialis. Echogenicity was used as proxy measure of muscle tissue composition, and muscle thickness values were used as a proxy measure of muscle mass.

Results: Lower echogenicity (D -3.04 grayscale levels, t=2.70, p=.01) and greater muscle thickness (D .17 cm, t=2.21, p=.03) of the rectus femoris were identified in the less involved limb. Additionally, the summed MUS muscle thickness values were associated with the Symptom and Sports/Recreation KOOS subscales (r=.37–.39, p=.02–.03). When considering individual muscle morphometry in the analyses, the muscle thickness of the deltoid was the only measure associated with all 5 KOOS subscales (r=.36–.45, p=.01–.04).

Conclusions: MUS-based measures of muscle morphology and morphometry identified knee OA asymmetries in older adult Veterans. Key upper extremity muscle groups and proxy estimates of lean body mass should not be overlooked as factors that affect the KOOS score. Future work should explore the role of lean body mass in the management of knee OA, and determine if changes in rectus femoris echogenicity and muscle thickness are associated with disease status.

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This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

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Comments

To be presented at GW Annual Research Days 2017.

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The association between musculoskeletal ultrasound measures and knee arthritis status in older Veterans

Background: Radiography is routinely used to assess knee osteoarthritis (OA), a degenerative condition involving articular cartilage and skeletal muscle. However, OA radiographic features do not consistently agree with patient-reported quality of life and other imaging modalities may offer better clinical utility. Diagnostic musculoskeletal ultrasound (MUS) can characterize muscle tissue structure and composition in knee OA. However, less is known about the association between MUS findings and patient symptomology. The purpose of this study is to determine whether quantitative MUS measures of skeletal muscle morphology and morphometry are associated with clinical markers of knee OA.

Methods: Male Veterans with knee OA (n=36; age=62.2 ±5.7 yr; BMI=31.2 ±6.5) participated in the study. Self-reported symptoms and physical function were evaluated using the Knee injury and Osteoarthritis Outcome Score (KOOS). Knee OA asymmetry was determined by the Kellgren–Lawrence grade and self-reported pain. B-mode quantitative MUS with a 13-6 MHz linear array transducer were used to obtain tissue echogenicity and muscle thickness values. The primary scanning site was the rectus femoris of the participants more and less involved leg. Additional sites included the trapezius, deltoid, pectoralis major, and brachioradialis. Echogenicity was used as proxy measure of muscle tissue composition, and muscle thickness values were used as a proxy measure of muscle mass.

Results: Lower echogenicity (D -3.04 grayscale levels, t=2.70, p=.01) and greater muscle thickness (D .17 cm, t=2.21, p=.03) of the rectus femoris were identified in the less involved limb. Additionally, the summed MUS muscle thickness values were associated with the Symptom and Sports/Recreation KOOS subscales (r=.37–.39, p=.02–.03). When considering individual muscle morphometry in the analyses, the muscle thickness of the deltoid was the only measure associated with all 5 KOOS subscales (r=.36–.45, p=.01–.04).

Conclusions: MUS-based measures of muscle morphology and morphometry identified knee OA asymmetries in older adult Veterans. Key upper extremity muscle groups and proxy estimates of lean body mass should not be overlooked as factors that affect the KOOS score. Future work should explore the role of lean body mass in the management of knee OA, and determine if changes in rectus femoris echogenicity and muscle thickness are associated with disease status.