Ultrasound of subtalar joint synovitis in patients with rheumatoid arthritis: Results of an omeract reliability exercise using consensual definitions

Maria Antonietta D'Agostino, George A.W. Bruyn, Heidi J. Siddle, Petra Hanova, Félicie Costantino, Annamaria Iagnocco, Andrea Delle Sedie, Marwin Gutierrez, Hilde B. Hammer, Elizabeth Jernberg, Damien Loeille, Mihaela C. Micu, Ingrid Moller, Carlos Pineda, Bethan Richards, Maria S. Stoenoiu, Takeshi Suzuki, Lene Terslev, Violeta Vlad, Robert WoninkMaria-Antonietta D'Agostino

Risultato della ricerca: Contributo in rivistaArticolo in rivista

2 Citazioni (Scopus)

Abstract

Objective. To evaluate the intraobserver and interobserver reliability of the ultrasonographic (US) assessment of subtalar joint (STJ) synovitis in patients with rheumatoid arthritis (RA). Methods. Following a Delphi process, 12 sonographers conducted an US reliability exercise on 10 RA patients with hindfoot pain. The anteromedial, posteromedial, and posterolateral STJ was assessed using B-mode and power Doppler (PD) techniques according to an agreed US protocol and using a 4-grade semiquantitative grading score for synovitis [synovial hypertrophy (SH) and signal] and a dichotomous score for the presence of joint effusion (JE). Intraobserver and interobserver reliability were computed by Cohen's and Light's k. Weighted k coefficients with absolute weighting were computed for B-mode and PD signal. Results. Mean weighted Cohen's k for SH, PD, and JE were 0.80 (95% CI 0.62-0.98), 0.61 (95% CI 0.48-0.73), and 0.52 (95% CI 0.36-0.67), respectively. Weighted Cohen's k for SH, PD, and JE in the anteromedial, posteromedial, and posterolateral STJ were -0.04 to 0.79, 0.42-0.95, and 0.28-0.77; 0.31-1, -0.05 to 0.65, and -0.2 to 0.69; 0.66-1, 0.52-1, and 0.42-0.88, respectively. Weighted Light's k for SH was 0.67 (95% CI 0.58-0.74), 0.46 (95% CI 0.35-0.59) for PD, and 0.16 (95% CI 0.08-0.27) for JE. Weighted Light's k for SH, PD, and JE were 0.63 (95% CI 0.45-0.82), 0.33 (95% CI 0.19-0.42), and 0.09 (95% CI -0.01 to 0.19), for the anteromedial; 0.49 (95% CI 0.27-0.64), 0.35 (95% CI 0.27-0.4), and 0.04 (95% CI -0.06 to 0.1) for posteromedial; and 0.82 (95% CI 0.75-0.89), 0.66 (95% CI 0.56-0.8), and 0.18 (95% CI 0.04-0.34) for posterolateral STJ, respectively. Conclusion. Using a multisite assessment, US appears to be a reliable tool for assessing synovitis of STJ in RA.
Lingua originaleEnglish
pagine (da-a)351-359
Numero di pagine9
RivistaTHE JOURNAL OF RHEUMATOLOGY
Volume46
DOI
Stato di pubblicazionePubblicato - 2019

Keywords

  • Adult
  • Arthritis, Rheumatoid
  • Consensus
  • Delphi Technique
  • Female
  • Humans
  • Incidence
  • Joint Ultrasound
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Research Design
  • Rheumatoid arthritis
  • Subtalar
  • Subtalar Joint
  • Synovitis
  • Ultrasonography, Doppler

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