Ultrasound Assessment of Talar, Femoral and Metacarpal Cartilage Thicknesses in Hemiplegic Patients and their Relationship with Functional Parameters.

BACKGROUND

In hemiplegic patients, joint cartilage alterations may arise from impaired balance reactions, decreased selective motor control, abnormal muscle tone, or reduced weight shifting toward the affected limb.

OBJECTIVE

This study aimed to investigate the thickness of talar, femoral, and metacarpal cartilage on the paretic and nonparetic sides in hemiplegic patients and to compare these findings with those of healthy controls.

METHODS

Thirty-one hemiplegic patients and 31 age and sex-matched healthy individuals participated. The thickness of talar, femoral, 2nd metacarpal, and 3rd metacarpal cartilage was measured using an ultrasound device equipped with a linear probe. Measurements were performed by the same experienced examiner to ensure reliability.

RESULTS

Talar (p = 0.012, r = 0.453) and femoral (p = 0.016, r = 0.431) cartilage were significantly thicker on the paretic side compared with the nonparetic side, while no differences were found in 2nd and 3rd metacarpal cartilage. Compared with controls, talar (p = 0.018, r = 0.299) and femoral (p = 0.036, r = 0.266) cartilage on the paretic side was thicker, whereas the nonparetic side showed no significant difference (p > 0.05).

CONCLUSIONS

The increased talar and femoral cartilage thickness on the paretic side could potentially be consistent with cartilage oedema or other structural changes; however, ultrasonography alone cannot differentiate between structural thickening, increased water content, subclinical synovitis, or methodological artefacts. Several alternative mechanisms may also contribute to the observed findings, including altered joint alignment, muscular imbalance, and spasticity-related loading changes secondary to hemiplegia. These findings warrant further investigation with longitudinal and multimodal imaging studies.