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. 2022 Dec;74(12):2005-2012.
doi: 10.1002/acr.24734. Epub 2022 Aug 31.

Ultrasonography of Inflammatory and Structural Lesions in Hand Osteoarthritis: An Outcome Measures in Rheumatology Agreement and Reliability Study

Alexander Mathiessen  1 , Hilde B Hammer  2 , Lene Terslev  3 , Marion C Kortekaas  4 , Maria A D'Agostino  5 , Ida K Haugen  1 , George A Bruyn  6 , Georgios Filippou  7 , Emilio Filippucci  8 , Margreet Kloppenburg  4 , Luana Mancarella  9 , Peter Mandl  10 , Ingrid Möller  11 , Mohamed A Mortada  12 , Esperanza Naredo  13 , Andrea Delle Sedie  14 , Joseph Sexton  1 , Ruth Wittoek  15 , Annamaria Iagnocco  16 , Karen Ellegaard  17 ; OMERACT Ultrasound Working Group
Collaborators, Affiliations
Free article

Ultrasonography of Inflammatory and Structural Lesions in Hand Osteoarthritis: An Outcome Measures in Rheumatology Agreement and Reliability Study

Alexander Mathiessen et al. Arthritis Care Res (Hoboken). 2022 Dec.
Free article

Abstract

Objective: To standardize and assess the reliability of ultrasonographic assessment of inflammatory and structural lesions in patients with hand osteoarthritis (OA).

Methods: The Outcome Measures in Rheumatology Ultrasound Working Group selected synovial hypertrophy (SH), joint effusion (JE), and power Doppler (PD) signals as the main inflammatory lesions in hand OA, and suggested osteophytes in the scapho-trapezio-trapezoid (STT) and cartilage defects in the proximal interphalangeal (PIP) joints as novel additions to previous structural scoring systems. A complementary imaging atlas provided detailed examples of the scores. A reliability exercise of static images was performed for the inflammatory features, followed by a patient-based exercise with 6 sonographers testing inflammatory and structural features in 12 hand OA patients. We used Cohen's kappa for intrareader and Light's kappa for interreader reliability for all features except PD, in which prevalence-adjusted bias-adjusted kappa (PABAK) was applied. Percentage agreement was also assessed.

Results: The web-based reliability exercise demonstrated substantial intra- and interreader reliability for all inflammatory features (κ > 0.64). In the patient-based exercise, intra- and interreader reliability, respectively, varied: SH κ = 0.73 and 0.45; JE κ = 0.70 and 0.55; PD PABAK = 0.90 and 0.88; PIP joint cartilage κ = 0.56 and 0.45; and STT osteophytes κ = 0.62 and 0.36. Percentage close agreement was high for all features (>85%).

Conclusion: With ultrasound, substantial to excellent intrareader reliability was found for inflammatory features of hand OA. Interreader reliability was moderate, but overall high close agreement between readers suggests that better reliability is achievable after further training. Assessment of osteophytes in the STT joint and cartilage in the PIP joints achieved less reliability and the latter is not endorsed.

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References

REFERENCES

    1. Kloppenburg M, Kwok WY. Hand osteoarthritis: a heterogeneous disorder. Nat Rev Rheumatol 2011;8:22-31.
    1. Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Rheum Dis Clin North Am 2008;34:515-29.
    1. Keen HI, Wakefield RJ, Grainger AJ, Hensor EM, Emery P, Conaghan PG. An ultrasonographic study of osteoarthritis of the hand: synovitis and its relationship to structural pathology and symptoms. Arthritis Rheum 2008;59:1756-63.
    1. Vlychou M, Koutroumpas A, Malizos K, Sakkas LI. Ultrasonographic evidence of inflammation is frequent in hands of patients with erosive osteoarthritis. Osteoarthritis Cartilage 2009;17:1283-7.
    1. Wittoek R, Carron P, Verbruggen G. Structural and inflammatory sonographic findings in erosive and non-erosive osteoarthritis of the interphalangeal finger joints. Ann Rheum Dis 2010;69:2173-6.

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