Reliability and validity of ultrasound imaging of features of knee osteoarthritis in the community

Abstract

BackgroundRadiographs are the main outcome measure in epidemiological studies of osteoarthritis (OA). Ultrasound imaging has unique advantages in that it involves no ionising radiation, is easy to use and visualises soft tissue structures. Our objective was to measure the inter-rater reliability and validity of ultrasound imaging in the detection of features of knee OA.MethodsEighteen participants from a community cohort, had both knees scanned by two trained musculoskeletal sonographers, up to six weeks apart. Inter-rater reliability for osteophytes, effusion size and cartilage thickness was calculated by estimating Kappa (κ) and Intraclass correlation coefficients (ICC), as appropriate. A measure of construct validity was determined by estimating κ between the two imaging modalities in the detection of osteophytes.ResultsReliability: κ for osteophyte presence was 0.77(right femur), 0.65(left femur) and 0.88 for both tibia. ICCs for effusion size were 0.70(right) and 0.85(left). Moderate to substantial agreement was found in cartilage thickness measurements. Validity: For osteophytes, κ was moderate to excellent at 0.52(right) and 0.75(left).ConclusionSubstantial to excellent agreement was found between ultrasound observers for the presence of osteophytes and measurement of effusion size; it was moderate to substantial for femoral cartilage thickness. Moderate to substantial agreement was observed between ultrasound and radiographs for osteophyte presence.

Acute Ankle Sprain in a Mouse Model: Changes in Knee-Joint Space

“…17,24 All measurements were taken by 1 investigator who was blinded to group assignment. Intertester and intratester reliability were previously established 17 for the investigator obtaining the measurements.…”

“…From this location, the distance from the medial or lateral condyle of the femur to the medial or lateral condyle of the tibia was measured to identify joint space for the respective hind limb. 24 Diminished knee-joint space is a clinical indicator of knee OA development.…”

Atlas-based knee osteophyte assessment with ultrasonography and radiography: relationship to arthroscopic degeneration of articular cartilage

“…With regard to the detection of osteophytes, it has been shown that US can detect more osteophytes than CR in the small joints of the hand (4,5). In the case of the tibiofemoral joint, the inter-reader agreement for detecting the presence of osteophytes by US is reported to range from substantial to excellent according to two experienced sonographers (6). However, there are no studies systematically comparing the performance of US and CR in the detection of osteophytes in the tibiofemoral joint using arthroscopy as a reference for the OA stage.…”

To evaluate the role of high resolution ultrasonography in diagnosis of knee osteoarthritis

“…Whereas there is increasing evidence of the validity of ultrasonography in detecting structural pathology in inflammatory arthritis, more work is required to develop standardized definitions of pathology and to demonstrate the validity of ultrasonography in osteoarthritis. [9] Study was conducted by Abraham et al (2011) to measure the inter-rater reliability and validity of ultrasound imaging in the detection of features of knee OA and found that Reliability for osteophyte presence was 0.77(right femur), 0.65(left femur) and 0.88 for both tibia. ICCs for effusion size were 0.70(right) and 0.85(left).…”

“…Moderate to substantial agreement was observed between ultrasound and radiographs for osteophyte presence. [10] Kazam et al (2011) did a sonographic evaluation of femoral trochlear cartilage in patients with knee pain. The purpose of this study was to investigate whether routine clinical sonographic evaluation of femoral trochlear cartilage can identify abnormalities in patients with knee pain.…”