High resolution ultrasound evaluation of synovial thickness as a marker to assess response to deep tissue heating for pain relief in knee osteoarthritis

Background: High-resolution ultrasound (HRUS) is a useful tool in assessing synovial tissue response to deep tissue heating (DTH)/short wave diathermy (SWD) for pain relief in knee osteoarthritis. Shortwave (SW) diathermy can be used to improve vascular circulation and reduce inflammation and pain in patients with osteoarthritis. The purpose of this study was to assess the role of ultrasound in investigating whether repetitive SW diathermy, could reduce synovial thickening in patients with knee osteoarthritis. Materials and Methods: Synovial thickness measurement of superior, medial, and lateral patellar recesses was done using ultrasonography over a span of nineteen months from April 2010 to Nov 2011 following three sessions of short wave diathermy. The sum of these three measurements was taken as the total synovial thickness and pre and post test analysis was done using primer statistical software. Result: Synovial thickening continued to become significantly thinner with sessions of treatment and after the twelfth SW diathermy treatment, there was 20.58% reduction in the synovial thickening. Conclusion: Synovial thickness is a sensitive marker in gauging the response to short wave diathermy therapy. Synovial thickness is an objective marker to assess pain relief in knee osteoarthritis following deep tissue heating