中瀬 順介

Junsuke NAKASE

金沢大学大学院整形外科

Department of Orthopaedic Surgery, School of Medicine, Kanazawa University

キーワード : osteoarthritis, knee, ultrasonography, diagnosis, intervention

変形性膝関節症による膝関節痛に対する注射療法は，膝関節内に行うことがこれまでの常識であった．しかし，運動器領域での超音波診療の普及に伴い，これまでの画像診断ツールでは見えなかった病態が見え，出来なかったインターベンションが出来るようになり，常識が変化しつつある．膝関節痛に対する運動器超音波診療のコツは超音波解剖を理解することであり，層状構造を解剖学的に把握することが重要である．変形性膝関節症による膝内側部痛では圧痛点を正確に把握し，同部位に正確に超音波ガイド下で注射を行うことで病態を把握し，新しい保存療法につながる．本稿では変形性膝関節症の診断と診かた，内側部痛に対する超音波ガイド下注射について解説する．

Injection for knee joint pain caused by osteoarthritis has conventionally been performed via intracapsular injection. However, with the spread of ultrasound diagnosis and treatment in the field of musculoskeletal disorders, the conventional wisdom is changing as we can see pathologies of diseases that could not be seen with conventional diagnostic imaging tools and perform interventions that could not be performed with conventional imaging tools. The key to musculoskeletal ultrasound for knee pain is to understand the ultrasonographic anatomy, and it is important to understand the anatomy of the laminar structures. In the case of medial knee pain caused by osteoarthritis of the knee, the tenderness points can be accurately identified and ultrasound-guided injections can be accurately performed in the same area to understand the pathophysiology and lead to new conservative therapies. This article describes the diagnosis of osteoarthritis of the knee and ultrasound-guided injection for medial knee pain.