• Chawanvuth Termtanun Department of Orthopedics, Phramongkutklao Hospital, Bangkok
  • Thanainit Chotanaphuti Department of Orthopedics, Phramongkutklao Hospital, Bangkok
  • Saradech Khuangsirikul Department of Orthopedics, Phramongkutklao Hospital, Bangkok
  • Danai Heebtamai Department of Orthopedics, Phramongkutklao Hospital, Bangkok



Ultrasonogram, Radiographic staging, Osteoarthritic knee, Synovitis, Synovial hypertrophy


Background: Treatment of primary osteoarthritic (OA) knee has changed in recent decades with a greater focus on synovitis as one cause of cartilage destruction and degeneration. Ultrasonography (US), a noninvasive, low cost and convenient procedure may be used for early detection and monitoring synovitis in primary OA knee. Somehow, the lack of data on the prevalence of synovial hypertrophy (SH) and its correlation to disease progression has precluded the use of US in clinical practice.

Objective: The study aimed to determine the prevalence of SH at each stage of the disease and its correlation to structural damage.

Methods: In all, 214 knees among 127 cases diagnosed as having primary OA knee were examined using US. The midline scanning technique of US was performed and synovial thickness at the suprapatellar pouch was observed. All knees were categorized according to the Kellgren-Lawrence radiographic staging (KL). The prevalence of SH in each KL with 2, 2.5 and 3 mm cutoff level were calculated. The correlation between synovial thickness and KL was also analyzed.

Results: The prevalence of SH with 2 mm cutoff level in KL I-IV was 38.8, 70.8, 66.6 and 91.1%, respectively. The prevalence of SH with 2.5 mm cutoff level in KL I-IV was 5.5, 37.5, 35.4 and 74.2%, respectively. The prevalence of SH with 3 mm cutoff level in KL I-IV was 0, 29.1, 20.8 and 56.4%, respectively. The overall prevalence with 2, 2.5 and 3 mm cut-off level was 72.2, 50.9 and 37.1%, respectively. Synovial thickness, measured in millimeters, correlated well with KL (p<0.01). The correlation of synovial thickness between each KL was also statistically significant (p<0.05) except those between KL II and KL III (p=0.98).

Conclusion: Synovial thickness at the suprapatellar pouch detected with midline scanning US reflected the degree of synovitis which correlated well with structural damage and could be used to monitor disease progression in primary OA knee.


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How to Cite

Termtanun C, Chotanaphuti T, Khuangsirikul S, Heebtamai D. SYNOVIAL HYPERTROPHY DETECTED USING ULTRASONOGRAM IN PRIMARY OSTEOARTHRITIC KNEES: PREVALENCE AND CORRELATIONWITH RADIOGRAPHIC STAGING. J Southeast Asian Med Res [Internet]. 2020 Jun. 23 [cited 2024 Feb. 21];4(1):33-40. Available from:



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