Effects of Repetitive Shortwave Diathermy for Reducing Synovitis in Patients With Knee Osteoarthritis - Research Paper Example

Methodological approach studies used humans as their subjects. Data were extracted from thirty participants with 44 osteoarthritic knees contributed to this study. Eleven subjects received SW, and 10 subjects received SW and non-steroidal anti-inflammatory drugs. Nine subjects received no treatment and served as a control group. Synovial sac thickness superior, medial, and lateral to the patella was measured using ultrasonography. The sum of these 3 measurements was taken as the total synovial sac thickness. Subjects in the treatment groups underwent ultrasonography examination before and after 10, 20, and 30 treatments, whereas control subjects underwent ultrasonography examination before the experiment and then once every 2 or 3 weeks for a total of 3 follow-up measurements. After 10 SW diathermy treatments, the total synovial sac thickness in both treatment groups was significantly less than the initial thickness, and the synovial sac continued to become significantly thinner with 20 sessions of treatment. These observations were not made in the control subjects.

The outcome indicates that SW diathermy in patients with knee osteoarthritis can meaningfully reduce both synovial thickness and knee pain. Such reductions of synovial sac thickness and pain index continue over treatment sessions (Jan MH, et. al). Whereas there is increasing evidence of the cogency of ultrasonography in detecting structural pathology in inflammatory arthritis, and more work is required to develop and demonstrate the validity of ultrasonography in osteoarthritis, particularly in synovitis. Therefore, the result of this study shows that ultrasonography is a beneficial tool to quantitatively detect changes in synovial thickness in the knee joint following SW diathermy therapy (Karim et al. and van Holsbeeck et al. 242).

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Regarding the personal reaction to the article, this review demonstrates the start of the new age.  There has been an amassed indication of the application of ultrasonography to osteoarthritis. However, for ultrasonography to be fully useful in assessing therapies and responses, it first needs to be corroborated as an outcome tool. In this review, manuscripts that use ultrasonography to evaluate osteoarthritis/synovitis and demonstrated that further work is required to validate ultrasonography in osteoarthritis had been presented.

Usually, the descriptions of ultrasonography technicalities, such as information about the machine and probe specifications and the position of the scan in obtaining images were adequately described. Whereas ultrasonography can be observed to be more sensitive for the detection of synovitis in osteoarthritis than clinical examination, with realistic sensitivity compared with MRI or histology, there is a slight indication to confirm the validity of ultrasonography in detecting bony pathology in osteoarthritis, and the evidence regarding the detection of cartilage pathology is basically limited to the detection of focal cartilage thickness.

The clinical utility of ultrasonography in detecting cartilage was examined, as the physical properties of ultrasonography make load-bearing cartilage difficult to image reliably due to acoustic shadowing. This review has also highlighted a rareness of information on the responsiveness of ultrasonography in osteoarthritis and a lack of information about the possibility of this imaging technique. Furthermore, there is a lack of reliability in the data presented in the literature with regards to inter-reader and intra-reader reliability in image acquisition and the scoring of stored images. Based on a personal point of view, ultrasonography is an imaging technique that may be useful in the diagnosis and management of osteoarthritis, both in clinical trials and in practice. The application of this imaging methodology to osteoarthritis has aided the understanding of the disease process, the relationship between structure and symptoms and may aid in the assessment of future therapies. However, the article evaluations have demonstrated reasonable endorsement of ultrasonography.

The performance metrics setting human subjects as proof were evaluated using criterion and construct validity, reliability, and responsiveness to change in osteoarthritis using shortwave diathermy as an effective tool for reducing pain and swelling and promoting healing in tissues with chronic swelling as it increases vascular movement and change tissue temperature, as sessions of diathermy are continued to ameliorate both synovial thickness and pain index as treatment session stays. The information stated in the article is generally very advantageous in undertaking a systematic review of the published literature evaluating ultrasonography as an assessment tool in osteoarthritis.