Assessing elementary lesions in gout by ultrasound: Results of an OMERACT patient-based agreement and reliability exercise

Lene Terslev, Marwin Gutierrez, Robin Christensen, Peter V. Balint, George A. Bruyn, Andrea Delle Sedie, Emilio Filippucci, Jesus Garrido, Hilde B. Hammer, Annamaria Iagnocco, David Kane, Gurjit S. Kaeley, Helen Keen, Peter Mandl, Esperanza Naredo, Carlos Pineda, Bernd Schicke, Ralf Thiele, Maria Antonietta D'Agostino, Wolfgang A. SchmidtIngrid Möller, David Bong, Marcin Szkudlarek, Eugenio De Miguel, Veronica Sharp, Christian Dejaco, Eugene Kissin, Petra Hanova, Frederique Gandjbakhch, Jane Freeston, Juhani Koski, Nanno Swen, Oscar Epis, Sibel Aydin, Viviana Ravagnani, Anthony Reginato, Richard J. Wakefield

Risultato della ricerca: Contributo in rivistaArticolo in rivista

36 Citazioni (Scopus)


Objective. To test the reliability of the consensus-based ultrasound (US) definitions of elementary gout lesions in patients. Methods. Eight patients with microscopically proven gout were evaluated by 16 sonographers for signs of double contour (DC), aggregates, erosions, and tophi in the first metatarsophalangeal joint and the knee bilaterally. The patients were examined twice using B-mode US to test agreement and inter- and intraobserver reliability of the elementary components. Results. The prevalence of the lesions were DC 52.8%, tophus 61.1%, aggregates 29.8%, and erosions 32.4%. The intraobserver reliability was good for all lesions except DC, where it was moderate. The best reliability per lesion was seen for tophus (κ 0.73, 95% CI 0.61-0.85) and lowest for DC (κ 0.53, 95% CI 0.38-0.67). The interobserver reliability was good for tophus and erosions, but fair to moderate for aggregates and DC, respectively. The best reliability was seen for erosions (κ 0.74, 95% CI 0.65-0.81) and lowest for aggregates (κ 0.21, 95% CI 0.04-0.37). Conclusion. This is the first step to test consensus-based US definitions on elementary lesions in patients with gout. High intraobserver reliability was found when applying the definition in patients on all elementary lesions while interobserver reliability was moderate to low. Further studies are needed to improve the interobserver reliability, particularly for DC and aggregates.
Lingua originaleEnglish
pagine (da-a)2149-2154
Numero di pagine6
Stato di pubblicazionePubblicato - 2015


  • Aged
  • Delphi Technique
  • Denmark
  • Exercise
  • Female
  • Gout
  • Humans
  • Knee Joint
  • Male
  • Metatarsophalangeal Joint
  • Middle Aged
  • Observer Variation
  • Omeract
  • Reliability
  • Reproducibility of Results
  • Sampling Studies
  • Severity of Illness Index
  • Ultrasonography
  • Uricosuric Agents


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