Knee Pain Examined under Musculoskeletal Ultrasonography: Experience from a Community-based Rheumatology Practice – A Cross-sectional Study

Md Abu Bakar Siddiq1, 2, *
, Mohammad Abdur Rahim3
1 Department of Physical Medicine and Rehabilitation, Brahmanbaria Medical College, Brahmanbaria, Bangladesh
2 Department of Rheumatology, University of South Wales, Pontypridd, United Kingdom
3 Department of Physical Medicine and Rehabilitation, Cox’s Bazar Medical College, Bangladesh

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Creative Commons License
© 2023 Siddiq et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Physical Medicine and Rheumatology, Brahmanbaria Medical College, Brahmanbaria, Bangladesh; Department of Rheumatology, University of South Wales, Pontypridd, United Kingdom; E-mail:



Diagnostic musculoskeletal ultrasonogram (MSUS) in musculoskeletal pain practice has increased. MSUS helps delineate extra-and intra-articular structures that are not visible on X-ray.


Explore knee pain under ultrasonogram in a primary care rheumatology (PCR) facility.


This cross-sectional study was performed over six months (January 1 and June 30, 2021) to explore knee pain in a community-based PCR setting. A physician registered in musculoskeletal (RMSK) ultrasonogram examined all patients and documented data in a prefabricated questionnaire. Statistical Package for the Social Sciences (SPSS, was used to analyze data. Quantitative and categorical variables were presented with frequency and percentage. The Mann-Whitney-U test assessed the correlation between categorical variables; p<0.05 was considered statistically significant.


A total of 118 knees of 92 patients were included. Following are MSUS-depicted structural changes: medial joint line osteophytes (91.3%), medial femoral condyle (MFC), cartilage echogenicity (78.3%), synovial plica (76%), knee effusion (61.9%), synovial membrane thickening (54.3%), increased medial collateral ligament (MCL) thickness (42.4), reduced trochlear and MFC thickness (36.9%), Baker's cyst (35.8%), increased MFC thickness (31.5%), medial meniscal extrusion (MME) (27.2%), synovial hypertrophy (20.6%), increased trochlear cartilage thickness (20.6%), MM tear (18.5%), semitendinosus (SMT) bursitis (6.5%), loose body (6.5%), frond-like synovial mass (5.4%), MCL calcification (4.3%) and MM cyst (4.3%). There was a statistically significant correlation between the following variables: Knee effusion and synovial plica; reduced MFC thickness; MME and reduced MFC thickness and moderate osteophyte.


High-frequency diagnostic ultrasound can depict knee pathology precisely. MSUS at the primary healthcare facility can minimize patient referral and burden over the tertiary setting and reduce overall expenditure.

Keywords: Knee, Pain, Osteoarthritis, Ultrasonography, Cross-sectional study, Community-based clinic.