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.

Academic Unit of Musculoskeletal Disease University of Leeds Leeds UK

Department of Rheumatology Charite University Hospital Berlin Germany

Department of Rheumatology Clinica Reumatologica Universitá Politecnica delle Marche Jesi Ancona Italy

Department of Rheumatology Copenhagen University Hospital at Glostrup Copenhagen Denmark

Department of Rheumatology Hospital General Universitario Gregorio Marañón Madrid Spain

Department of Rheumatology Institute of Rheumatology Prague Czech Republic

Department of Rheumatology Instituto Poal Barcelona Spain

Department of Rheumatology National Institute of Rehabilitation Mexico City Mexico

Department of Rheumatology National Institute of Rheumatology and Physiotherapy Budapest Hungary

Department of Rheumatology Sapienza Università di Roma Rome Italy

Department of Rheumatology Université Paris Ouest Versailles Saint Quentin en Yvelines Hôpital Ambroise Paré APHP Boulogne Billancourt France

Department of Rheumatology VU Medisch Centrum Amsterdam The Netherlands

Department of Social Psychology and Methodology Faculty of Psychology Autonoma University Madrid Spain

Rheumatology Department MC Groep Hospitals Lelystad The Netherlands

Technology Centre ASCR Prague Czech Republic

Citace poskytuje Crossref.org

The MCP2 and the wrist plus two extensor compartments are the most affected and responsive joints/tendons out of the US7 score in patients with rheumatoid arthritis-an observational study