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Ultrasound definition of tendon damage in patients with rheumatoid arthritis. Results of a OMERACT consensus-based ultrasound score focussing on the diagnostic reliability

GA. Bruyn, P. Hanova, A. Iagnocco, MA. d'Agostino, I. Möller, L. Terslev, M. Backhaus, PV. Balint, E. Filippucci, P. Baudoin, R. van Vugt, C. Pineda, R. Wakefield, J. Garrido, O. Pecha, E. Naredo, . ,

. 2014 ; 73 (11) : 1929-1934.

Language English Country England, Great Britain

Document type Consensus Development Conference, Journal Article, Research Support, Non-U.S. Gov't

Persistent link   https://www.medvik.cz/link/bmc15008579

Grant support
NT12437 MZ0 CEP Register

OBJECTIVE: To develop the first ultrasound scoring system of tendon damage in rheumatoid arthritis (RA) and assess its intraobserver and interobserver reliability. METHODS: We conducted a Delphi study on ultrasound-defined tendon damage and ultrasound scoring system of tendon damage in RA among 35 international rheumatologists with experience in musculoskeletal ultrasound. Twelve patients with RA were included and assessed twice by 12 rheumatologists-sonographers. Ultrasound examination for tendon damage in B mode of five wrist extensor compartments (extensor carpi radialis brevis and longus; extensor pollicis longus; extensor digitorum communis; extensor digiti minimi; extensor carpi ulnaris) and one ankle tendon (tibialis posterior) was performed blindly, independently and bilaterally in each patient. Intraobserver and interobserver reliability were calculated by κ coefficients. RESULTS: A three-grade semiquantitative scoring system was agreed for scoring tendon damage in B mode. The mean intraobserver reliability for tendon damage scoring was excellent (κ value 0.91). The mean interobserver reliability assessment showed good κ values (κ value 0.75). The most reliable were the extensor digiti minimi, the extensor carpi ulnaris, and the tibialis posterior tendons. An ultrasound reference image atlas of tenosynovitis and tendon damage was also developed. CONCLUSIONS: Ultrasound is a reproducible tool for evaluating tendon damage in RA. This study strongly supports a new reliable ultrasound scoring system for tendon damage.

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$a OBJECTIVE: To develop the first ultrasound scoring system of tendon damage in rheumatoid arthritis (RA) and assess its intraobserver and interobserver reliability. METHODS: We conducted a Delphi study on ultrasound-defined tendon damage and ultrasound scoring system of tendon damage in RA among 35 international rheumatologists with experience in musculoskeletal ultrasound. Twelve patients with RA were included and assessed twice by 12 rheumatologists-sonographers. Ultrasound examination for tendon damage in B mode of five wrist extensor compartments (extensor carpi radialis brevis and longus; extensor pollicis longus; extensor digitorum communis; extensor digiti minimi; extensor carpi ulnaris) and one ankle tendon (tibialis posterior) was performed blindly, independently and bilaterally in each patient. Intraobserver and interobserver reliability were calculated by κ coefficients. RESULTS: A three-grade semiquantitative scoring system was agreed for scoring tendon damage in B mode. The mean intraobserver reliability for tendon damage scoring was excellent (κ value 0.91). The mean interobserver reliability assessment showed good κ values (κ value 0.75). The most reliable were the extensor digiti minimi, the extensor carpi ulnaris, and the tibialis posterior tendons. An ultrasound reference image atlas of tenosynovitis and tendon damage was also developed. CONCLUSIONS: Ultrasound is a reproducible tool for evaluating tendon damage in RA. This study strongly supports a new reliable ultrasound scoring system for tendon damage.
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$a Hánová, Petra $u Department of Rheumatology, Institute of Rheumatology, Prague, Czech Republic. $7 xx0176691
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$a Iagnocco, Annamaria $u Department of Rheumatology, Sapienza Università di Roma, Rome, Italy.
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$a d'Agostino, Maria-Antonietta $u Department of Rheumatology, Université Paris Ouest-Versailles-Saint Quentin en Yvelines, Hôpital Ambroise Paré, APHP, Boulogne-Billancourt, France.
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$a Möller, Ingrid $u Department of Rheumatology, Instituto Poal, Barcelona, Spain.
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$a Terslev, Lene $u Department of Rheumatology, Copenhagen University Hospital at Glostrup, Copenhagen, Denmark.
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$a Backhaus, Marina $u Department of Rheumatology, Charite University Hospital, Berlin, Germany.
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$a Balint, Peter V $u Department of Rheumatology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary.
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$a Filippucci, Emilio $u Department of Rheumatology, Clinica Reumatologica, Universitá Politecnica delle Marche, Jesi, Ancona, Italy.
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$a Baudoin, Paul $u Rheumatology Department, MC Groep Hospitals, Lelystad, The Netherlands.
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$a Wakefield, Richard $u Academic Unit of Musculoskeletal Disease, University of Leeds, Leeds, UK.
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$a Garrido, Jesus $u Department of Social Psychology and Methodology, Faculty of Psychology, Autonoma University, Madrid, Spain.
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$a Naredo, Esperanza $u Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
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