Clinimetrics of ultrasound pathologies in osteoarthritis: systematic literature review and meta-analysis

Oo, Win Min; Linklater, James; Daniel, Matthew; Saarakkala, Simo; Samuels, Jonathan; Conaghan, Philip G.; Keen, Helen; Deveza, Leticia A

doi:10.1016/j.joca.2018.01.021

Cited by 32 publications

(38 citation statements)

References 73 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, and in contrast to MRI, it is a widely available and inexpensive imaging method ( 13 ). Additionally, US features such as joint space narrowing and synovitis have been found to better correlate with pain than structural damage ( 23 , 24 ), and US might be good tool to measure changes in clinical trials ( 13 , 14 , 25 ).…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have shown US to be reliable and valid for the evaluation of cartilage pathology in OA, and especially for large joints such as the knee ( 26 – 29 ), and US has demonstrated strong criterion validity with cartilage histology ( 25 ). The knee's hyaline cartilage has a normal thickness of 2 mm, and superficial regions can easily be evaluated by US ( 26 , 27 ).…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies demonstrated that US is as sensitive as MRI and more sensitive than conventional radiography for the detection of osteophytes ( 25 , 26 , 31 – 34 ), and showed a high intra and inter-reader agreement ( 26 – 28 , 35 ). In this cohort, ultrasonography had a sensitivity of 95% (CI95% 92–98) for the detection of hyaline cartilage involvement or osteophytes, and a specificity of 86% (CI95% 80–92) for the identification of osteophytes, compared to conventional radiography.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Performance of Ultrasonography Compared to Conventional Radiography for the Diagnosis of Osteoarthritis in Patients With Knee Pain

et al. 2020

View full text Add to dashboard Cite

To investigate the performance of ultrasonography (US) for the detection of knee osteoarthritis (OA) in patients suffering from knee pain, compared to conventional radiographs. Methods: Cross-sectional study performed at a university teaching hospital. Consecutive patients complaining of unilateral or bilateral mechanical knee pain who signed an informed consent were included. All patients underwent simultaneously an ultrasonographic and a radiographic evaluation of the knee. Exclusion criteria were age under 18 years, prior diagnosis of knee OA, diagnosis of inflammatory arthritis, history of knee surgery or trauma, severe knee deformities, and corticosteroid injection within the last 2 months. The diagnostic properties of US for the detection of knee OA were evaluated using radiological data as the reference method. Evaluated test properties were sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the positive and negative likelihood ratio (LR+ and LR-). Results: Three-hundred twenty-two knees (281 patients) were included. Radiographic degenerative changes were present in 56.8% (183) of the evaluated knees. Regarding the diagnostic properties of the US, the presence of either osteophytes or the compromise of the femoral hyaline cartilage had the best sensitivity to detect OA (95%), with a NPV of 92% and a LR-of 0,07, while the combined identification of osteophytes and compromise of the femoral hyaline cartilage had the best specificity (94%), with 94% PPV and a LR+ of 13. Conclusion: US demonstrated an excellent sensitivity with an adequate specificity for the detection of radiographic knee OA.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Performance of Ultrasonography Compared to Conventional Radiography for the Diagnosis of Osteoarthritis in Patients With Knee Pain

et al. 2020

View full text Add to dashboard Cite

show abstract

“…This study showed that synovitis, when present, were mostly scored toward the lower end of the semi-quantitative scale as these grading scores were adopted from the scoring system created originally for rheumatoid arthritis [23], which is quantitatively different in inflammatory severity from OA [28]. Recent papers questioned the use or relevance of semi-quantitative scores in OA as it can lead to unequal distribution of the scores [29] and floor effects causing less sensitivity to detect an improvement in interventional trials [30].…”

Section: Discussionmentioning

confidence: 99%

Musculoskeletal ultrasound in symptomatic thumb-base osteoarthritis: clinical, functional, radiological and muscle strength associations

Deveza

Duong

et al. 2019

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Thumb-base osteoarthritis (OA) is a common cause of pain and disability This study aimed to investigate the associations of musculoskeletal ultrasound OA pathologies with the extent of pain, function, radiographic scores, and muscle strength in symptomatic thumb-base osteoarthritis. Methods This is a cross-sectional study of an ongoing clinical trial with eligibility criteria including thumb-base pain on Visual Analogue Scale (VAS) ≥40 (0 to 100 mm), Functional Index for Hand OA (FIHOA) ≥ 6 (0 to 30) and Kellgren Lawrence (KL) grade ≥ 2. The most symptomatic side was scanned to measure synovitis and osteophyte severity using a 0–3 semi-quantitative score, power Doppler and erosion in binary score. A linear regression model was used for associations of ultrasound findings with VAS pain, FIHOA and hand grip and pinch strength tests after adjusting for age, gender, body mass index, disease duration and KL grade as appropriate. For correlation of ultrasound features with KL grade, OARSI ((Osteoarthritis Research Society International) osteophyte and JSN scores, Eaton grades, Spearman coefficients were calculated, and a significant test defined as a p -value less than 0.05. Results The study included 93 participants (mean age of 67.04 years, 78.5% females). Presence of power Doppler has a significant association with VAS pain [adjusted β coefficient = 11.29, P = 0.02] while other ultrasound pathologies revealed no significant associations with all clinical outcomes. In comparison to radiograph, ultrasonographic osteophyte score was significantly associated with KL grade [r s = 0.44 ( P < 0.001)], OARSI osteophyte grade [r s = 0.35 ( P = 0.001)], OARSI JSN grade [r s = 0.43 (P < 0.001)] and Eaton grade [r s = 0.30 ( P < 0.01)]. Ultrasonographic erosion was significantly related with radiographic erosion [r s = − 0.49 (P = 0.001)]. Conclusion From a clinical perspective the significant relationship of power Doppler with pain severity in thumb base OA suggests this might be a useful tool in understanding pain aetiology. It is important to recognise that power Doppler activity was only detected in 14% of the study so this might be an important subgroup of persons to monitor more closely. Trial registration Registered at Australian New Zealand Clinical Trials Registry (ANZCTR), http://www.anzctr.org.au/ , ACTRN12616000353493.

show abstract

“…7 Acceptable reliability of ultrasound-specific lesions provides the foundation for diagnostic or epidemiological studies using ultrasound imaging, but only a few previous studies have investigated the reliability of hip ultrasound in OA and they have mostly investigated individual findings and only by interpreting the same images. 6 Therefore, studies that include the differences in acquisition of images between the two operators in the assessment of reliability on ultrasound findings in people with hip OA are needed.…”

mentioning

confidence: 99%

Ultrasound imaging in patients with hip pain and suspected hip osteoarthritis: an inter-rater and intra-rater reliability study

et al. 2020

View full text Add to dashboard Cite

ObjectivesThe objectives of this study were to asses (1) inter-rater and intrarater reliability of ultrasound imaging in patients with hip osteoarthritis, and (2) agreement between ultrasound and X-ray findings of hip osteoarthritis using validated Outcome Measures in Rheumatology ultrasound definitions for pathology.DesignAn inter-rater and intrarater reliability study.SettingA single-centre study conducted at a regional hospital.Participants50 patients >39 years of age referred for radiography due to hip pain and suspected hip osteoarthritis were included. Exclusion criteria were previous hip surgery in the painful hip, suspected fracture or malignant changes in the hip.InterventionBilateral ultrasound examinations (n=92) were performed continuously by two experienced operators blinded to clinical information and other imaging findings. After 4–6 weeks, one operator reassessed the images. X-rays were assessed by a third imaging specialist.Primary and secondary outcome measuresInter-rater and intrarater reliability and agreement between ultrasound imaging and X-ray were assessed using Cohen’s ordinal kappa statistics for binary categorical variables and weighted kappa for ordered categorical variables.ResultsKappa values (κ) for inter-rater reliability were 0.9 and 0.8 for hip effusion/synovitis and osteoarthritis grading, respectively. For acetabular and femoral osteophytes, femoral cartilage changes and labrum changes κ ranged from 0.4 to 0.7. Intrarater reliability had κ equal or higher compared with inter-rater reliability. Agreement between ultrasound and X-ray findings ranged from κ=0.2 to κ=0.5.ConclusionThis study demonstrated substantial to almost perfect reliability on the most common ultrasound findings related to hip osteoarthritis and osteoarthritis grading. Agreement on the grade of osteoarthritis between ultrasound and X-ray was moderate. Overall, these results support ultrasound imaging as a reliable tool in the assessment of hip osteoarthritis.

show abstract

Clinimetrics of ultrasound pathologies in osteoarthritis: systematic literature review and meta-analysis

Abstract: CRD42016039954.

Cited by 32 publications

References 73 publications

Performance of Ultrasonography Compared to Conventional Radiography for the Diagnosis of Osteoarthritis in Patients With Knee Pain

Performance of Ultrasonography Compared to Conventional Radiography for the Diagnosis of Osteoarthritis in Patients With Knee Pain

Musculoskeletal ultrasound in symptomatic thumb-base osteoarthritis: clinical, functional, radiological and muscle strength associations

Ultrasound imaging in patients with hip pain and suspected hip osteoarthritis: an inter-rater and intra-rater reliability study

Contact Info

Product

Resources

About