OBJECTIVES: To investigate the reliability of the OMERACT US Task Force definition of US enthesitis in SpA. METHODS: In this web exercise, based on the evaluation of 101 images and 39 clips of the main entheses of the lower limbs, the elementary components included in the OMERACT definition of US enthesitis in SpA (hypoechoic areas, entheseal thickening, power Doppler signal at the enthesis, enthesophytes/calcifications, bone erosions) were assessed by 47 rheumatologists from 37 rheumatology centres in 15 countries. Inter- and intra-observer reliability of the US components of enthesitis was calculated using Light's kappa, Cohen's kappa, Prevalence And Bias Adjusted Kappa (PABAK) and their 95% CIs. RESULTS: Bone erosions and power Doppler signal at the enthesis showed the highest overall inter-reliability [Light's kappa: 0.77 (0.76-0.78), 0.72 (0.71-0.73), respectively; PABAK: 0.86 (0.86-0.87), 0.73 (0.73-0.74), respectively], followed by enthesophytes/calcifications [Light's kappa: 0.65 (0.64-0.65), PABAK: 0.67 (0.67-0.68)]. This was moderate for entheseal thickening [Light's kappa: 0.41 (0.41-0.42), PABAK: 0.41 (0.40-0.42)], and fair for hypoechoic areas [Light's kappa: 0.37 (0.36-0.38); PABAK: 0.37 (0.37-0.38)]. A similar trend was observed in the intra-reliability exercise, although this was characterized by an overall higher degree of reliability for all US elementary components compared with the inter-observer evaluation. CONCLUSIONS: The results of this multicentre, international, web-based study show a good reliability of the OMERACT US definition of bone erosions, power Doppler signal at the enthesis and enthesophytes/calcifications. The low reliability of entheseal thickening and hypoechoic areas raises questions about the opportunity to revise the definition of these two major components for the US diagnosis of enthesitis.

2nd Internal Medicine Department Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca Romania

CEMIC Centro de investigaciones médicas Norberto Quirno Buenos Aires Argentina

Centre for Experimental Medicine Queen's University Belfast

Department of Clinical and Molecular Sciences Rheumatology Unit Carlo Urbani Hospital Polytechnic University of Marche Jesi Ancona

Department of Emergency and Organ Transplants Rheumatology Unit Bari

Department of Health Promotion Mother and Child Care Internal Medicine and Medical Specialties Rheumatology section University of Palermo Palermo Italy

Department of Internal Medicine Ospedale Madonna del Soccorso San Benedetto del Tronto Marche Italy

Department of Medicine Internal Medicine and Rheumatology Unit Azienda Ospedaliero Universitaria di Parma Parma Italy

Department of Orthopedic Surgery Osaka Metropolitan University Graduate School of Medicine Osaka Japan

Department of Paediatric and Adult Rheumatology University Hospital Motol Prague Czech Republic

Department of Rheumatology and Immunology The 1st Medical Centre Chinese PLA General Hospital Beijing China

Department of Rheumatology Clinical Immunology and Allergy University Hospital of Heraklion Greece

Department of Rheumatology Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou China

Department of Rheumatology Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca Romania

Department of Rheumatology School of Health Science Faculty of Medicine University of Ioannina Ioannina Greece

Department of Rheumatology University Hospitals Dorset NHS Foundation Trust Christchurch Hospital Christchurch UK

Department of Statistics and Quantitative Methods Division of Biostatistics Epidemiology and Public Health University of Milano Bicocca Milan Italy

Division de Reumatologia Instituto Nacional de Rehabilitacion Luis Guillermo Ibarra Ibarra Mexico City Mexico

Division of Rheumatology Department of Internal Medicine Faculty of Medicine Hacettepe University Ankara Turkey

Division of Rheumatology Sherbrooke University Sherbrooke Canada

Epidemiology Unit Italian Society of Rheumatology Milan Italy

Faculdade de Medicina Coimbra University Coimbra Portugal

Faculty of Health Sciences University of Beira Interior Covilhã Portugal

Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo Sao Paulo SP Brazil

Hospital Italiano de Buenos Aires Buenos Aires Argentina

Internal Medicine and Rheumatology Department Dr 1 Cantacuzino Clinical Hospital Bucharest Romania

Rheumatology Clinic ATS Sardegna Medicina Specialistica Ambulatoriale Oristano Nuoro

Rheumatology Department Betsi Cadwaladr University Health Board Glan Clwyd Hospital Bodelwyddan Denbighshire UK

Rheumatology Department Centro Hospitalar de Leiria Leiria

Rheumatology Department Hokkaido Medical Center for Rheumatic Diseases Sapporo Japan

Rheumatology Department Internal Medicine Clinic Kalmar County Hospital Kalmar Sweden

Rheumatology Department Queen Alexandra Hospital Portsmouth UK

Rheumatology Department University of Medicine and Pharmacy of Craiova Craiova Romania

Rheumatology Hospital Provincial Rosario Argentina

Rheumatology Liverpool University Hospitals Foundation Trust Liverpool UK

Rheumatology Unit Instituto de Rehabilitación Psicofísica Buenos Aires Argentina

Rheumatology Unit Policlinico S Orsola Malpighi Bologna Italy

Rheumatology Unit Vall d'Hebron Hospital Universitari Vall d'Hebron Barcelona Hospital Campus Barcelona Spain

San Roque Hospital La Plata Buenos Aires Argentina

SSD Reumatologia Ospedale Sant'Andrea di Vercelli Vercelli Italy

University of Ottawa Ottawa Hospital Research Institute Ottawa Ontario Canada

Rheumatology (Oxford). 2022 Nov 28;61(12):4581-4582. doi: 10.1093/rheumatology/keac380. PubMed

Citace poskytuje Crossref.org

Reliability assessment of ultrasound muscle echogenicity in patients with rheumatic diseases: Results of a multicenter international web-based study