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Validation and incorporation of digital entheses into a preliminary GLobal OMERACT Ultrasound DActylitis Score (GLOUDAS) in psoriatic arthritis
E. Naredo, MA. D'Agostino, L. Terslev, C. Pineda, MI. Miguel, J. Blasi, GA. Bruyn, MC. Kortekaas, P. Mandl, R. Nestorova, M. Szkudlarek, P. Todorov, V. Vlad, P. Wong, C. Bakewell, E. Filippucci, A. Zabotti, M. Micu, F. Vreju, M. Mortada, JA....
Language English Country England, Great Britain
Document type Journal Article, Validation Study
NLK
ProQuest Central
from 1939-01-01 to 6 months ago
Health & Medicine (ProQuest)
from 1939-01-01 to 6 months ago
Family Health Database (ProQuest)
from 1939-01-01 to 6 months ago
ROAD: Directory of Open Access Scholarly Resources
- MeSH
- Delphi Technique MeSH
- Adult MeSH
- Enthesopathy diagnostic imaging MeSH
- Finger Joint * diagnostic imaging pathology MeSH
- Middle Aged MeSH
- Humans MeSH
- Cadaver MeSH
- Observer Variation MeSH
- Fingers diagnostic imaging pathology MeSH
- Arthritis, Psoriatic * diagnostic imaging MeSH
- Reproducibility of Results MeSH
- Aged MeSH
- Feasibility Studies MeSH
- Severity of Illness Index * MeSH
- Synovitis diagnostic imaging pathology MeSH
- Tenosynovitis diagnostic imaging MeSH
- Ultrasonography * methods MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Validation Study MeSH
OBJECTIVES: The main objective was to generate a GLobal OMERACT Ultrasound DActylitis Score (GLOUDAS) in psoriatic arthritis and to test its reliability. To this end, we assessed the validity, feasibility and applicability of ultrasound assessment of finger entheses to incorporate them into the scoring system. METHODS: The study consisted of a stepwise process. First, in cadaveric specimens, we identified enthesis sites of the fingers by ultrasound and gross anatomy, and then verified presence of entheseal tissue in histological samples. We then selected the entheses to be incorporated into a dactylitis scoring system through a Delphi consensus process among international experts. Next, we established and defined the ultrasound components of dactylitis and their scoring systems using Delphi methodology. Finally, we tested the interobserver and intraobserver reliability of the consensus- based scoring systemin patients with psoriatic dactylitis. RESULTS: 32 entheses were identified in cadaveric fingers. The presence of entheseal tissues was confirmed in all cadaveric samples. Of these, following the consensus process, 12 entheses were selected for inclusion in GLOUDAS. Ultrasound components of GLOUDAS agreed on through the Delphi process were synovitis, tenosynovitis, enthesitis, subcutaneous tissue inflammation and periextensor tendon inflammation. The scoring system for each component was also agreed on. Interobserver reliability was fair to good (κ 0.39-0.71) and intraobserver reliability good to excellent (κ 0.80-0.88) for dactylitis components. Interobserver and intraobserver agreement for the total B-mode and Doppler mode scores (sum of the scores of the individual abnormalities) were excellent (interobserver intraclass correlation coefficient (ICC) 0.98 for B-mode and 0.99 for Doppler mode; intraobserver ICC 0.98 for both modes). CONCLUSIONS: We have produced a consensus-driven ultrasound dactylitis scoring system that has shown acceptable interobserver reliability and excellent intraobserver reliability. Through anatomical knowledge, small entheses of the fingers were identified and histologically validated.
3rd Rheumatology Department National Institute of Musculoskeletal Diseases Budapest Hungary
Autonomous University of Madrid Madrid Spain
Center for Rheumatology and Spine Diseases Rigshospitalet Copenhagen Denmark
Department of Internal Medicine 3 Division of Rheumatology Medical University Vienna Wien Austria
Department of Rheumatology Flevoziekenhuis Almere The Netherlands
Department of Rheumatology Hospital Universitario Ramón y Cajal Madrid Spain
Department of Rheumatology Institute of Rheumatology Prague Czech Republic
Department of Rheumatology Leiden University Medical Centre Leiden The Netherlands
Department of Rheumatology Tallaght University Hospital Dublin Ireland
Department of Rheumatology Zealand's University Hospital Køge Denmark
Histology Unit Faculty of Medicine and Health Sciences University of Barcelona Barcelona Spain
Instituto Poal de Reumatología Barcelona Spain
Intermountain Health Care Inc Salt Lake City Utah USA
Musculoskeletal Radiology Group Medical Imaging Clinic Semmelweis University Budapest Hungary
Reumakliniek Flevoland Lelystad Netherlands
Rheumatology Center St Irina Sofia Bulgaria
Rheumatology Clinical Hospital Sf Maria Bucharest Romania
Rheumatology Department Faculty of Medicine Zagazig University Zagazig Egypt
Rheumatology Department University of Medicine and Pharmacy Craiova Craiova Romania
Rheumatology Unit IRCCS Sacro Cuore Don Calabria Negrar Italy
School of Medicine University of Western Australia Perth Western Australia Australia
Tergooi MC Hospital Hilversum and Reumakliniek Lelystad Lelystad Netherlands
University of Florida College of Medicine Jacksonville Florida USA
References provided by Crossref.org
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