The OMERACT Ultrasound Group: A Report from the OMERACT 2016 Meeting and Perspectives

Terslev, Lene; Iagnocco, Annamaria; Bruyn, G. A. W.; Naredo, Esperanza; Vojinović, Jelena; Collado, Paz; Damjanov, Nemanja; Filer, Andrew; Filippou, Georgios; Finzel, Stephanie; Gandjbakhch, Frédérique; Ikeda, Kei; Keen, Helen; Kortekaas, M.C.; Magni‐Manzoni, Silvia; Ohrndorf, Sarah; Pineda, Carlos; Ravagnani, Viviana; Richards, Bethan; Sahbudin, Ilfita; Schmidt, Wolfgang A.; Siddle, Heidi J.; Stoenoiu, Maria; Szkudlarek, Marcin; Tzaribachev, Nikolay; D'Agostino, Maria Antonietta

doi:10.3899/jrheum.161240

Cited by 10 publications

(5 citation statements)

References 16 publications

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“…In contrast to a preliminary ultrasonographic scoring system for hand OA that combined SH and JE into 1 greyscale synovitis score (15), we demonstrated that SH and JE can be scored separately on 0–3 scales. This finding is similar to recent OMERACT studies of rheumatoid arthritis (RA) of the hand (33) and OA of the foot (34), except that those studies scored JE as absent/present (0–1). In our study, both features were tested in the patient‐based exercise and reached substantial intrareader agreement in dorsal scans of the interphalangeal joints, and moderate agreement between readers.…”

Section: Discussionsupporting

confidence: 87%

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

Mathiessen

Hammer

Terslev

et al. 2022

Arthritis Care & Research

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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 (OMERACT) 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 six sonographers testing inflammatory and structural features in twelve hand OA patients. We used Cohen's kappa (κ) for intra-reader and Light's κ for inter-reader 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 inter-reader reliability for all inflammatory features (κ>0.64). In the patient-based exercise, intra-and inter-reader reliability varied: SH κ=0.73 and 0.45; JE κ=0.70 and 0.55; PD PABAK=0.90 and 0.88; PIP cartilage κ=0.56 and 0.45; STT osteophytes κ=0.62 and 0.36. Percentage close agreement was high for all features (>85%). Conclusion:With ultrasound, substantial to excellent intra-reader reliability was found for inflammatory features of hand OA. Inter-reader reliability was moderate, but overall high close agreement between readers suggest that better reliability is achievable after further training.Assessment of osteophytes in the STT joint and cartilage in the PIP joints achieved less good reliability and the latter is not endorsed.

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Section: Discussionsupporting

confidence: 87%

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

Mathiessen

Hammer

Terslev

et al. 2022

Arthritis Care & Research

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“…Musculoskeletal ultrasound (MSUS) is a noninvasive, efficient modality for the assessment of inflammatory arthritis . In adult rheumatology, the clinical and research use of MSUS has become a routine point‐of‐care procedure; however, there are a limited number of studies of MSUS in juvenile idiopathic arthritis (JIA) and pediatric rheumatology .…”

Section: Introductionmentioning

confidence: 99%

Novel Ultrasound Image Acquisition Protocol and Scoring System for the Pediatric Knee

Ting

Vega‐Fernandez

Oberle

et al. 2019

Arthritis Care & Research

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“…In each joint, three elements were assessed: synovial hyperplasia, synovial effusion, and the power Doppler signal (pD). The MSUS examiner expressed a binary judgment of the articulation (normal or pathological according to OMERACT indications in children) [5]; in pathological articulations, each of the three elements (hyperplasia, synovial, pD) was expressed with a 0 to 3 grade, according to OMERACT indications in children [5,6], considering age-related vascularization [7].…”

Section: Clinical Examination and Msus Evaluationmentioning

confidence: 99%

Discordance between Clinical and Ultrasound Examinations in Juvenile Idiopathic Arthritis: An Experimental Approach

et al. 2022

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Clinical examination (CE) and musculoskeletal ultrasound (MSUS) of ten joints (knee, ankle, wrist, elbow, II-MCP) and their extra-articular (EA) compartments (tendons and bursae) were performed on 35 consecutive patients with active juvenile idiopathic arthritis (JIA) (active group) to test how the extension of MSUS examinations to EA changes the concordance between MSUS and CE. The overall concordance between CE and MSUS, measured with Cohen’s Kappa (k), was moderate (k = 0.43); the addition of EA MSUS increased the concordance in all joints, with the exclusion of II-MCP (k = 0.49). In the ankle and wrist, the k increase was relevant (k from 0.13 to 0.27 and 0.11 to 0.41). In the active group patients, we observed 44 subclinical synovitis; the number of subclinical synovitis per patient was correlated with JADAS-27 (p = 0.03) and was higher in a control group composed of 15 patients with persistent disease remission (1.3 vs. 0.4 p = 0.03). Our results show that EA compartments should always be evaluated during MSUS. Furthermore, we demonstrate a moderate concordance between CE and MSUS in JIA; the finding of subclinical synovitis is common in patients with active diseases and is related to disease activity.

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The OMERACT Ultrasound Group: A Report from the OMERACT 2016 Meeting and Perspectives

Abstract: The first step has been taken to define the threshold for minimal disease activity in RA by US and to define and develop a scoring system for synovitis in JIA. Further steps are planned for the continuous validation of US in these areas.

Cited by 10 publications

References 16 publications

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

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

Novel Ultrasound Image Acquisition Protocol and Scoring System for the Pediatric Knee

Discordance between Clinical and Ultrasound Examinations in Juvenile Idiopathic Arthritis: An Experimental Approach

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