Validation of a 40 MHz B-scan ultrasound biomicroscope for the evaluation of osteoarthritis lesions in an animal model

Objective: To evaluate high frequency (40 MHz) B-mode ultrasound for the detection of osteoarthritis (OA) lesions of varying severity in an animal model of OA. Design: Ultrasound biomicroscopy (UBM) was performed on the femoral articular surface of adult rabbits with unilateral transection of the anterior cruciate ligament at 4, 8 and 12 weeks post-surgery and on control rabbits. The articular cartilage was examined and graded macroscopically and histologically for OA lesions. Histological examination was used as a reference to determine sensitivity and specificity of ultrasonographic and macroscopic examination regarding fibrillation and ulceration of articular cartilage. Results: Identification of slight surface irregularities was made possible with UBM. The sensitivity and specificity of UBM were 92.3% and 96.4%, respectively, to detect histological fibrillation and 90.9% and 97.6%, respectively, to identify histological ulceration. Macroscopic examination using India Ink had a sensitivity and specificity of 80% and 96.4%, respectively, for fibrillation and 90.9% and 90.5%, respectively, for ulceration when compared to histology. A high correlation (r_sp = 0.90) was found between ultrasonographic and histological scores. Conclusions: UBM of articular cartilage reflects histological structure and can accurately detect early changes such as fibrillation. UBM has the potential to be a valuable tool for the in vivo identification of early lesions of OA and for monitoring the disease or efficacy of novel therapy if it can be packaged in a minimally invasive format suitable for intra-articular imaging.