Recommendations for the Use of Ultrasound and Magnetic Resonance in Patients With Spondyloarthritis, Including Psoriatic Arthritis, and Patients With Juvenile Idiopathic Arthritis

Usón, Jacqueline; Loza, Estíbaliz; Möller, Ingrid; Acebes, Carlos; Andreu, José Luís; Batlle, Enrique; Bueno, Ángel; Collado, Paz; Fernández-Gallardo, Juan Manuel; González, Carlos; Palop, Mercedes Jiménez; Macarrón, Pilar; Maymó, Joan; Narváez, José Antonio; Navarro-Compán, Victoria; Sanz, Jesús; Rosario, María Piedad; Vicente, Esther; Naredo, Esperanza

doi:10.1016/j.reumae.2016.08.007

Cited by 9 publications

(6 citation statements)

References 105 publications

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“…The mean and range of the level of agreement for each recommendation was calculated. A recommendation was approved when ≥70% of the expert group voted a NRS-agreement ≥7 [19].…”

Section: Methodsmentioning

confidence: 99%

Multidisciplinary recommendations for diagnosis and treatment of foot problems in people with rheumatoid arthritis

Tenten-Diepenmaat

Leeden

Vlieland

et al. 2018

Journal of Foot and Ankle Research

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BackgroundFoot problems in people with rheumatoid arthritis (RA) are highly prevalent and have a substantial impact on quality of life. Healthcare professionals from various professions can be involved in the management of these foot problems. There is currently no consensus on optimal management. Therefore, the aim of the present study was to develop multidisciplinary recommendations for the management of foot problems in people with RA in the Netherlands.MethodsThe recommendations were based on research evidence and consensus among experts, following published strategies for the development of practice recommendations. The expert group was composed of 2 patients and 22 experienced professionals (rheumatologists, rehabilitation physicians, orthopaedic surgeons, specialized nurses, podiatrists, orthopaedic shoe technicians, pedicurists, and researchers) in the Netherlands. For each developed recommendation i) the level of evidence was determined, and ii) the level of agreement (among the expert group) was set by an anonymous voting procedure using a numeric rating scale. The mean and range of the level of agreement for each recommendation was calculated. A recommendation was approved when ≥70% of the expert group voted an NRS-agreement ≥7.ResultsIn total, 41 recommendations were developed. Two recommendations concerned a framework for diagnosis and treatment. Thirty-nine recommendations on foot care were developed: seven on diagnosis (including check-ups of feet and shoes and diagnostic imaging), 27 on treatment (including corticosteroid injections, foot surgery, therapeutic shoes, foot orthoses, exercise therapy, toe-orthoses and toenail-braces, treatment of toenails and skin), four on communication, and one on organisation of RA-related footcare. All recommendations were approved by the expert group. The percentage score of NRS-agreement ≥7 ranged from 80 to 100%.ConclusionsThese are the first published multidisciplinary recommendations specific to the management of foot problems in people with RA. Multidisciplinary recommendations can provide guidance in timely referrals and access to adequate footcare. More research is needed to strengthen the evidence on diagnosis and treatment of RA-related foot problems. These national recommendations may be a first step towards developing international multidisciplinary recommendations for the management of foot problems in RA.Electronic supplementary materialThe online version of this article (10.1186/s13047-018-0276-z) contains supplementary material, which is available to authorized users.

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“…The mean and range of the level of agreement for each recommendation was calculated. A recommendation was approved when ≥70% of the expert group voted a NRS-agreement ≥7 [19].…”

Section: Methodsmentioning

confidence: 99%

Multidisciplinary recommendations for diagnosis and treatment of foot problems in people with rheumatoid arthritis

Tenten-Diepenmaat

Leeden

Vlieland

et al. 2018

Journal of Foot and Ankle Research

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“…Several professional societies have contributed over time to the standardization, implementation, and training in MSUS. In Europe, significant work has been carried out by the European League Against Rheumatism (EULAR), European Society of Musculoskeletal Radiology (ESSR), and European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) [1][2][3][4][5][6][7][8][9][10].…”

Section: General Considerationsmentioning

confidence: 99%

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound – Part I: Extraarticular Pathologies

et al. 2021

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The first part of the guidelines and recommendations for musculoskeletal ultrasound, produced under the auspices of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB), provides information about the use of musculoskeletal ultrasound for assessing extraarticular structures (muscles, tendons, entheses, ligaments, bones, bursae, fasciae, nerves, skin, subcutaneous tissues, and nails) and their pathologies. Clinical applications, practical points, limitations, and artifacts are described and discussed for every structure. After an extensive literature review, the recommendations have been developed according to the Oxford Centre for Evidence-based Medicine and GRADE criteria and the consensus level was established through a Delphi process. The document is intended to guide clinical users in their daily practice.

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“…Over the last ten years, magnetic resonance imaging (MRI) has been regarded as the gold standard technique for the detection of acute injuries to the sacroiliac joints and spine [5][6][7][8][9][10] . However, it has certain limitations: it has low sensitivity in the initial stages of the disease (54 %) and only 30 % of patients with low back pain (LBP) present signs of sacroiliitis 11,12 ; only a few centers have rapid access to MRI with the required technical characteristics and not all SpA patients can undergo MRI, for reasons such as claustrophobia, pacemakers, vascular prostheses, etc.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of quantitative SPECT/CT in assessing active sacroiliitis in patients with axial spondylarthritis and/or inflammatory low back pain

Ornilla

Sancho

Beorlegui³

et al. 2022

An Sist Sanit Navar

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Background. The diagnostic accuracy of bone scintigraphy (BS) increases with SPECT/CT imaging. It would therefore be appropriate to reassess the diagnostic utility of scintigraphy in sacroiliitis with axial spondyloarthritis (SpA). The aim of this study was to compare the diagnostic performance of MRI, SPECT/CT and a combination of both techniques in sacroiliitis, and to evaluate the correlation between quantitative SPECT/CT indices and quantitative MRI inflammatory lesion scores.Methods. Thirty-one patients with active SpA and 22 patients with inflammatory low back pain underwent MRI and SPECT/CT of the sacroiliac joints. The diagnostic accuracy of both techniques was calculated using clinical diagnosis as the gold standard. The correlation between MRI and SPECT/CT was calculated by comparing the SPECT/CT activity indices and the Berlin/SPARCC scoring systems for MRI.Results. The sensitivity and specificity values in quantitative SPECT/CT, taking the sacroiliac/promontory ratio of >1.36 as the cut-off value, were close to those from MRI published in the literature. The combination of both techniques increased sensitivity while maintaining high specificity. There was a moderate correlation between SPECT/CT and MRI total scores. This correlation was improved by using solely the MRI inflammation scores. Conclusion.Quantitative SPECT/CT showed better diagnostic accuracy than planar scintigraphy and showed a moderate correlation with MRI scores in active sacroiliitis. The combination of both tests increased the diagnostic accuracy. Quantitative SPECT/CT could play a relevant role in the diagnosis of active sacroiliitis in patients with high a suspicion of SpA and a negative/ inconclusive MRI test or in patients with whom MRI studies cannot be carried out.

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Recommendations for the Use of Ultrasound and Magnetic Resonance in Patients With Spondyloarthritis, Including Psoriatic Arthritis, and Patients With Juvenile Idiopathic Arthritis

Cited by 9 publications

References 105 publications

Multidisciplinary recommendations for diagnosis and treatment of foot problems in people with rheumatoid arthritis

Multidisciplinary recommendations for diagnosis and treatment of foot problems in people with rheumatoid arthritis

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound – Part I: Extraarticular Pathologies

Diagnostic value of quantitative SPECT/CT in assessing active sacroiliitis in patients with axial spondylarthritis and/or inflammatory low back pain

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