Reproducibility of joint swelling assessment by sonography in patients with long-lasting rheumatoid arthritis (SEA-repro study part II)

Maria Antonietta D'Agostino, Sandrine Jousse-Joulin, Thierry Marhadour, Jean David Albert, Jacques Bentin, Isabelle Chary Valckenaere, Fabien Etchepare, Philippe Gaudin, Christophe Hudry, Gérard Chalès, Laurent Grange, Cécile Hacquard, Damien Loeuille, Jérémie Sellam, Maxime Dougados, Alain Saraux

Risultato della ricerca: Contributo in rivistaArticolo in rivista

34 Citazioni (Scopus)

Abstract

Objective. To evaluate the intraobserver and interobserver reproducibility of B-mode and power Doppler (PD) sonography in patients with active long-standing rheumatoid arthritis (RA) comparatively with clinical data. Methods. In each of 7 patients being considered for a change in their RA treatment regimen, 7 healthcare professionals examined the 28 joints used in the Disease Activity Score 28-joint count (DAS28). Then 7 sonographers examined each of the 7 patients twice, using previously published B-mode and PD grading systems. The clinical reference standard was presence of synovitis according to at least 4/7 examiners. The sonographic reference standard was at least grade 1 (ALG1) or 2 (ALG2) synovitis according to at least 4/7 sonographers. Interobserver reproducibility of sonography was assessed versus the sonographer having the best intraobserver reproducibility. Agreement was measured by Cohen's kappa statistic. Results. Intraobserver and interobserver reproducibility of B-mode and PD used separately was fair to good.Agreement between clinicians and sonographers at all sites using B-mode, PD, and both was 0.46, 0.37, and 0.36, respectively, for grade 1 synovitis; and 0.58, 0.19, and 0.19 for grade 2 synovitis. The number of joints with synovitis was smaller by physical examination (36.7%) than by B-mode with ALG1 (58.6%; p < 0.001). The number of joints with synovitis was higher by physical examination than by PD with both ALG1 (17.8%; p < 0.0001) and ALG2 (6.6%; p < 0.0001). Conclusion. PD findings explain most of the difference between clinical and sonographic joint assessments for synovitis in patients with long-standing RA. The Journal of Rheumatology Copyright © 2010. All rights reserved.
Lingua originaleEnglish
pagine (da-a)938-945
Numero di pagine8
RivistaTHE JOURNAL OF RHEUMATOLOGY
Volume37
DOI
Stato di pubblicazionePubblicato - 2010

Keywords

  • Disease activity
  • Ultrasonography, Doppler
  • Synovitis
  • Ultrasound
  • Aged
  • Arthritis, Rheumatoid
  • Female
  • Humans
  • Joints
  • Male
  • Middle Aged
  • Reference Standards
  • Reproducibility of Results
  • Severity of Illness Index
  • Rheumatoid arthritis

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