Articular ultrasonography: Interobserver reliability in rheumatoid arthritis

Bisi, Melissa Cláudia; Prado, Aline Defaveri do; Rabelo, Cristina; Brollo, Flávia; Silveira, Inês Guimarães da; Mendonça, José Alexandre; Staub, Henrique Luiz

doi:10.1016/j.rbre.2013.09.002

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…In our own experience, we have been employing a 10-joint score exclusively of hand/wrist joints (dorsal aspects of wrists and second and third MCP, and volar aspect of second and third PIP joints of both hands). After evaluating 1380 joints of 60 RA patients, kappa agreement for synovitis ranged from fair to good (0.30-0.70); for cartilage changes, also from fair to good (0.28-0.63; for pD signal, from moderate to absolute agreement (0.53-1); and for erosions, from good to excellent (0.70-0.97) [80].…”

Section: Intra and Interobserver Agreementmentioning

confidence: 98%

“…The several studies [68][69][70][71][72][73][74][75][76][77][78][79][80][81][82] evaluating reliability of MSUS scores have revealed some variation. As a whole, MSUS seems very reliable for bone erosions (kappa ranging from good to excellent); in turn, the grade of agreement for synovitis, although generally moderate to good, has shown more fluctuation.…”

Section: Intra and Interobserver Agreementmentioning

confidence: 99%

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Ultrasound and its clinical use in rheumatoid arthritis: where do we stand?

et al. 2018

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High-resolution musculoskeletal ultrasound (MSUS) has been increasingly employed in daily rheumatological practice and in clinical research. In rheumatoid arthritis (RA), MSUS can be now considered a complement to physical examination. This method evaluates synovitis through gray-scale and power Doppler and it is also able to identify bone erosions. The utilization of MSUS as a marker of RA activity has received attention in recent literature. Current data account for good correlation of MSUS with classical measures of clinical activity; in some instances, MSUS appears to perform even better. Diagnosis of subclinical synovitis by MSUS might help the physician in RA management. With some variation, interobserver MSUS agreement seems excellent for erosion and good for synovitis. However, lack of MSUS score standardization is still an unmet need. In this review, we describe several MSUS scores, as well as their correlation with clinical RA activity and response to therapy. Finally, we look at the relationship of MSUS with synovial tissue inflammation and discuss future perspectives for a better interpretation and integration of this imaging method into clinical practice.

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Section: Intra and Interobserver Agreementmentioning

confidence: 98%

Section: Intra and Interobserver Agreementmentioning

confidence: 99%

Ultrasound and its clinical use in rheumatoid arthritis: where do we stand?

et al. 2018

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“…Several studies have shown that US can detect more erosion than X-ray, especially at the early stage of RA [ 7 ]. High-resolution musculoskeletal US can demonstrate consistent and reproducible results according to trained rheumatologists [ 8 ]. Despite increasing efforts on the validation and reliability of US in the evaluation of small joints, evidence for larger joints, such as the knee, is still limited [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Knee alterations in rheumatoid arthritis: Comparison of US and MRI

2021

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Objective This study was designed to compare the diagnostic efficacy of ultrasonography (US) and magnetic resonance imaging (MRI) in detecting changes in the knee of patients with rheumatoid arthritis (RA) and discover the possible association between the serological index and bone erosion detected by US. Patients and methods In this retrospective study, the US images and MRI findings of the knee in patients with RA from December 2017 to January 2020 were evaluated. Diagnostic outcomes were compared. The rheumatoid factor, C-reactive protein, erythrocyte sedimentation rate, and anti-cyclic citrullinated peptide antibody (ACPA) levels of the patients were recorded. The relation between laboratory index and US findings was analyzed by multivariable logistic regression. Results US showed remarkable accuracy, sensitivity, and specificity in diagnosing synovitis, bone erosion, and soft tissue swelling. In terms of reliability, the agreement between US and MRI was moderate to almost perfect. Meanwhile, a positive association between ACPA level and bone erosion was observed in patients with RA. Conclusions US may have a role as the initial imaging modality in patients with RA. Patients with higher ACPA levels may need more active treatment because they are more likely to have bone erosion detected by US.

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“…In recent years, high-resolution musculoskeletal ultrasound (MSUS) has been widely used in clinical rheumatology practice, since it has demonstrated consistent and reproducible results among trained rheumatologists [4]. Synovial proliferation seen on gray scale ultrasound (GS) and synovial power Doppler (pD) signal are characteristics of joint inflammation.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound inflammatory parameters and Treg/Th17 cell profiles in established rheumatoid arthritis

et al. 2019

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Background: Imbalance and disfuntion in regulatory T-cells (Tregs) and IL-17 producer lymphocytes (Th17) have been implicated in the pathogenesis of rheumatoid arthritis (RA). Gray scale synovial proliferation (GS), power Doppler signal (pD) and bone erosions seen on high resolution muskuloskeletal ultrasound (MSUS) are hallmarks of destructive articular disease. Objective: To evaluate the association of peripheral Tregs and Th17 with MSUS findings in RA. Methods: RA patients (1987 ACR criteria) treated with disease-modifying antirheumatic drugs (DMARDs) were included. Lymphocytes were isolated and immunophenotyped by flow cytometry to investigate regulatory FoxP3+ T cells and IL-17+ cells. MSUS (MyLab 60, Esaote, Genova, Italy, linear probe 6-18 MHz) was performed on hand joints, and a 10-joint US score was calculated for each patient. Results: Data on lymphocytes subsets were avaiable for 90 patients. The majority of patients were Caucasian women with a median disease duration of 6 years (interquartile range: 2-13 years). Mean DAS28 was 4.28 (SD ± 1.64) and mean HAQ score was 1.11 (SD ± 0.83). There was no significant correlation of 10-joint GS score (rS = 0.122, 95% CI: − 0.124 to 0.336, P = 0.254) and 10-joint pD score (rS = 0.056, 95% CI: − 0.180 to 0.273, P = 0.602) with the mean percentage of peripheral Treg cells. Also, 10-joint GS score (rS = 0.083, 95% CI: − 0.125 to 0.302, P = 0.438) and 10-joint pD score 10 (rS = − 0.060, 95% CI: − 0.271 to 0.150, P = 0.575); did not correlate to Th17 profile. No association of bone erosions on MSUS with Treg and Th17 profiles (P = 0.831 and P = 0.632, respectively) was observed. Conclusion: In this first study addressing MSUS features and lymphocytes subtypes in established RA, data did not support an association of circulating Tregs and Th17 lymphocytes with inflammatory and structural damage findings on MSUS.

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Articular ultrasonography: Interobserver reliability in rheumatoid arthritis

Cited by 4 publications

References 17 publications

Ultrasound and its clinical use in rheumatoid arthritis: where do we stand?

Ultrasound and its clinical use in rheumatoid arthritis: where do we stand?

Knee alterations in rheumatoid arthritis: Comparison of US and MRI

Ultrasound inflammatory parameters and Treg/Th17 cell profiles in established rheumatoid arthritis

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