Reliability of a consensus-based ultrasound definition and scoring for enthesitis in spondyloarthritis and psoriatic arthritis: an OMERACT US initiative

Bálint, Péter; Terslev, Lene; Aegerter, Philippe; Bruyn, George A W; Chary‐Valckenaere, Isabelle; Gandjbakhch, Frédérique; Iagnocco, Annamaria; Jousse‐Joulin, Sandrine; Möller, Ingrid; Naredo, Esperanza; Schmidt, Wolfgang A.; Wakefield, Richard J.; D'Agostino, Maria Antonietta

doi:10.1136/annrheumdis-2018-213609

Cited by 179 publications

(172 citation statements)

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“…For the heel's structures the patients was in a prone position with the foot hanging at the edge of the bed in a neutral position. Based on a preestablished protocol and according to EULAR-OMERACT recommendations, definitions and grading [5][6][7][8][9][10][11]22,23], tibiotalar (TT), talonavicular (TN) and subtalar (ST) joints synovitis, erosions and osteophytes were assessed, as well as tibialis anterior (TA), extensor hallucis longus (EHL), extensor digitorum communis (EDC), tibialis posterior (TP), flexor digitorum communis (FDC), flexor hallucis longus (FHL) and peroneal tendons tenosynovitis. In the heel region, the Achille's tendon, the presence of enthesophytes, retrocalcaneal bursitis, posterior and inferior calcaneal erosions, plantar fasciitis, perifasciitis and subcalcaneal panniculitis were evaluated.…”

Section: Ultrasoundmentioning

confidence: 99%

“…The US definitions and grading for synovitis, tenosynovitis, erosions, osteophytes, enthesophytes, retrocal-caneal bursitis and plantar fasciitis are well established by the European League Against Rheumatism/Outcome Measures in Rheumatology Clinical Trials (EULAR/ OMERACT) working groups [5][6][7][8][9][10], as well as the standardized US examination technique for each musculoskeletal region [11]. The MRI-OMERACT group elaborated MRI definitions for joint synovitis, tenosynovitis, bone erosions and bone edema [12] and developed a scoring system for the evaluation of inflammation and damage of the hand and wrist in RA patients -RA MRI scoring system (RAMRIS) [13].…”

Section: Introductionmentioning

confidence: 99%

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Reasons for discordances between ultrasonography and magnetic resonance imaging in the evaluation of the ankle, hindfoot and heel of the patients with rheumatoid arthritis

et al. 2019

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Aim: To compare the ultrasonography (US) performance with magnetic resonance imaging (MRI) in identifying pathology in ankles, hindfeet and heels of rheumatoid arthritis (RA) patients and to evaluate the reasons for discordances between the two imaging methods.Material and methods: RA patients were enrolled and evaluated using the Clinical Disease Activity Index (CDAI) and the Disease Activity Score 28 with C-reactive Protein (DAS28-CRP). The ankle (tibiotalar joint, tendons), hindfoot (talonavicular, subtalar joints) and heel of the most symptomatic or dominant foot (for the asymptomatic patient)were evaluated by two pairs of examiners using US and contrast-enhanced MRI.Results: Totally, 105 joints, 245 tendons and 35 heels in 35 patients [mean age 59.2±11.25 years old, median disease duration 36 (16.5-114), mean CDAI 19.87±12.7] were evaluated. The interobserver agreements between the two sonographers, and the two radiologists were good and very good (k=0.624-0.940). The overall agreement between US and MRI was very good for subcalcaneal panniculitis (k=0.928, p<0.001), moderate for synovitis (k=0.463, p<0.001) and tenosynovitis (k=0.514, p<0.001), fair for osteophytes (k=0.260, p=0.004), and poor for erosions (k=0.063, p=0.308) and heel’s structures. MRI found more erosions, synovitis, osteophytes,tenosynovitis and retrocalcaneal bursitis, but US found more enthesophytes and plantar fasciitis. Many of the discordancesbetween the two imaging techniques have explanations related to the technique itself or definition of the pathologic findings.Conclusions: US is comparable to MRI for the evaluation of ankle, hindfoot and heel in RA patients and discordances in theinterpretation of the pathological findings/normal structures must be carefully analyzed.

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Section: Ultrasoundmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reasons for discordances between ultrasonography and magnetic resonance imaging in the evaluation of the ankle, hindfoot and heel of the patients with rheumatoid arthritis

et al. 2019

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“…The US appearance of enthesitis can be defined as a combination of morphological changes in greyscale and inflammatory findings in Doppler mode 7,8,9,16 . The Outcome Measures in Rheumatology (OMERACT) US group has established a definition of enthesitis and the different elementary inflammatory and structural components that can be visualized (hypoechogenicity, thickening, bone erosion, enthesophytes, calcification, Doppler signal) at entheses, as well as their scoring 17,18 . The development and validation process were performed on both SpA and PsA, allowing a standardization of this tool for research.…”

Section: Editorialmentioning

confidence: 99%

“…A common US definition of enthesitis for the SpA group is therefore highly sought. This definition has been developed by the OMERACT US group 17 .…”

Section: Editorialmentioning

confidence: 99%

The Role of Ultrasound in Psoriatic Arthritis — Do We Need a Score?

D’Agostino

Coates

2019

J Rheumatol

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“…[1] Kelly C, Iqbal K, Iman-Gutierrez L, Evans P, Manchegowda K. Lung involvement in inflammatory rheumatic Diseases.…”

mentioning

confidence: 99%

Ab1158 clinical and Visual Us Parameters in Symptomatic Knee Osteoarthritis and Asymptomatic Patients

Martusevitch

Gudkevich

Алешкевич

et al. 2019

Abstracts Accepted for Publication

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BackgroundSonography is widely used because of its easy accessibility, relatively low cost. Sonography provides distinct information that bridges the gap between clinical and radiologic evaluation. There has been a growing interest in determining the sources of pain with ultrasound (US) findings in patients with knee osteoarthritis.ObjectivesThe aim of this study was to determine the relationships between clinical parameters and features of US of the knee.MethodsThis was a cross-sectional study, recruiting 47 consecutive patients aged 47 (36- 54), 60,42% (n=29) were female. Those with recent trauma, rheumatic diseases were excluded from the study. Patients underwent assessment for knee pain (Visual Analog Scale (VAS)), US examination of the knee joints according to the 4-point scale (synovial proliferation, joint effusion, power Doppler signal (PD), patellofemoral joint cartilage (PFJ), medial femoral cartilage (MF), medial (MM) and lateral meniscus (LM), osteophytes, Baker cysts). US staging of knee OA was also performed.ResultsPatients were divided into 2 groups: those with knee pain (n=28) and asymptomatic patients (n=19). Pathological US features were found in both groups (Table). In 5 out of 19asymptomatic patients, degenerative changes of different degree of the joint structures were identified (PFJ, MF, osteophytes, MM, LM), in 4 patients – joint effusion. Prevalence of PFJ, MF, MM, LM changes, osteophytes and Baker cysts didn’t differ between groupsG. roups differed in PD signal expression in the synovia (p=0,07). Functional association between VAS score and PD expression (R=1,0, p<0,05) was revealed$ moderate correlation between VAS score and joint effusion (R=0,47, p<0,05), PFJ (R=0,58, p<0,05), osteophytes (R=0,66, p<0,001) was observed.ConclusionIn the patients under study, degenerative and inflammatory findings were common in the symptomatic group, but were also identified in the asymptomatic patients. Clinical parameters were more strongly associated with active inflammation (as verified by US) rather than with degenerative changes.Disclosure of InterestsNone declared

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Reliability of a consensus-based ultrasound definition and scoring for enthesitis in spondyloarthritis and psoriatic arthritis: an OMERACT US initiative

Abstract: By using a consensus-based stepwise approach, a final reliable US score and definition of enthesitis in SpA/PsA were produced. Further studies are sought for implementing this score in clinical trials and practice.

Cited by 179 publications

References 23 publications

Reasons for discordances between ultrasonography and magnetic resonance imaging in the evaluation of the ankle, hindfoot and heel of the patients with rheumatoid arthritis

Reasons for discordances between ultrasonography and magnetic resonance imaging in the evaluation of the ankle, hindfoot and heel of the patients with rheumatoid arthritis

The Role of Ultrasound in Psoriatic Arthritis — Do We Need a Score?

Ab1158 clinical and Visual Us Parameters in Symptomatic Knee Osteoarthritis and Asymptomatic Patients

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