Correlations between ultrasonographic findings, clinical scores, and depression in patients with knee osteoarthritis

Objective: This study aimed to explore correlations between the presence of depression, clinical scores, and ultrasonographic (US) grading in osteoarthritis (OA) patients and to clarify if depressive symptoms might cause a discrepancy between US findings and clinical scores. Material and Methods: Two hundred patients with primary knee OA and 100 healthy hospital volunteers of the same age and sex not complaining of knee troubles participated in this study. We evaluated depressive symptoms in all participants using the Beck Depression Inventory (BDI) scale. Thorough clinical examination was performed, including assessment using the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) for disability. All patients underwent US examination of their affected knees. Results: Depression was detected in 60 patients with knee OA (30%) and in 5 controls (5%). The mean of BDI score was 12.8 +/- 12.2 in OA patients and 5.8 +/- 3.2 in controls, and this difference was statistically significant (p=0.03). Correlations of BDI with both body mass index (BMI) (p=0.04) and Numerical Rating Scale of Pain (NRSP) score (p=0.006) were significant, while correlations of BDI with both the ages of our patients (p=0.74) and their disease duration (p=0.88) were insignificant. There were statistically significant correlations between patients' disease duration and US measurements regarding osteophyte length, lateral femoral cartilage thickness, medial femoral cartilage thickness, and thickness of the quadriceps tendon despite of the presence of insignificant correlations between disease duration and both the effusion volume and volume of Baker's cysts. There were statistically significant correlations between patients' disease duration and US measurements except for effusion volume and volume of Baker's cysts. There were statistically significant correlations between the NRSP score in OA patients and BDI (p=0.006) and all US measurements apart from lateral femoral cartilage thickness, medial femoral cartilage thickness, and thickness of quadriceps tendon. There were statistically significant correlations between BDI in OA patients and the WOMAC (p=0.005), Kellgren-Lawrence (KL) grading (p=0.034), and US grading (p=0.041). Conclusion: The presence of knee effusion, Baker's cysts, osteophytes, and high BMI have a great impact on the pain and disability associated with OA. Higher clinical scores, radiographic scores, and US scores correlate with the emergence of depression in OA patients.