The OMERACT Ultrasound Task Force — Status and Perspectives

Naredo, Esperanza; Wakefield, Richard J.; Iagnocco, Annamaria; Terslev, Lene; Filippucci, Emilio; Gandjbakhch, Frédérique; Aegerter, Philippe; Aydın, Sibel Zehra; Backhaus, Marina; Bálint, Péter; Bruyn, G. A. W.; Collado, Paz; Finzel, Stephanie; Freeston, Jane; Gutiérrez, Marwin; Joshua, Fredrick; Jousse‐Joulin, Sandrine; Kane, David; Keen, Helen; Möller, Ingrid; Mandl, Péter; Ohrndorf, Sarah; Pineda, Carlos; Schmidt, Wolfgang A.; Szkudlarek, Marcin; Conaghan, Philip G.; D'Agostino, Maria Antonietta

doi:10.3899/jrheum.110425

Cited by 103 publications

(72 citation statements)

References 19 publications

(17 reference statements)

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“…The need for many steps in the development of these definitions emphasizes the lack of validation in the US assessment of pediatric joints, which are subject to great variability (2). Previous work done in adults by the OMERACT Ultrasound Group has shown that even assessments of single types of joints can be challenging and might need a relatively lengthy development process of precise definitions in order to achieve good intra-and interrater reliability of this method (14). Our study focused on the structures of the healthy joint but was restricted to the main structures of the diarthrodial joint.…”

Section: Discussionmentioning

confidence: 99%

“…Given the lack of definitions for normal sonoanatomy as well as synovitis in children (2), a task force for pediatric US was established within the Outcome Measures in Rheumatology (OMERACT) Ultrasound Group to start the essential process of standardization of US assessment in children. Standardization, including precise definitions for US findings, has been shown in adults to be essential for good interrater reliability (14). In order to reflect the variability of relevant anatomy according to age and maturity in children, a decision was taken to start with definitions of the components of the healthy joint first.…”

Section: Significance and Innovationsmentioning

confidence: 99%

“…An abundant number of studies have emerged in the literature over the past 2 decades for adult rheumatology, which included validation of the US detection of synovitis with histology and magnetic resonance imaging (MRI), standardization of the scanning technique, normative data acquisition, as well as documenting the responsiveness to change (11)(12)(13)(14)(15). These aspects have nevertheless only been partially addressed for pediatric patients (2,10,16); very few publications have started to collect information (16,17).…”

Section: Introductionmentioning

confidence: 99%

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Definitions for the Sonographic Features of Joints in Healthy Children

Roth

Jousse‐Joulin

Magni‐Manzoni

et al. 2014

Arthritis Care & Research

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Objective. Musculoskeletal ultrasonography (US) has potential in the assessment of disease activity and structural damage in childhood arthritides. In order to assess pathology, the US characteristics of joints in healthy children need to be defined first. The aim of this study was to develop definitions for the various components of the normal pediatric joint. Methods. The definitions were developed by an expert group and applicability was assessed on a collection of standardized scans of the knee and ankle joints by scoring the scans on a Likert scale. The definitions were then modified and applicability was reassessed before sending the definitions for approval to a larger panel of experts. A final scoring on stored images of all relevant joints at different ages followed. Results. Five definitions were developed addressing the articular bone, cartilage, joint capsule, epiphyseal ossification center, and synovial membrane. In total, 224 US images of knees and ankles were acquired, of which 172 were selected for scoring. An agreement of >80% was not met for any of the definitions, but after modifications, 81-97% agreement was reached. This version of the definitions was approved by 15 US experts. In the final validation exercise, all definitions reached an agreement of >80% for the shoulder, elbow, wrist, metacarpophalangeal hip, knee, ankle and metatarsophalangeal joint. Conclusion. US definitions for the normal pediatric joint were successfully developed through a Delphi process and validated in a practical exercise. These results provide the basis to develop definitions for pathology and to support the standardized use of US in pediatric rheumatology.

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Section: Discussionmentioning

confidence: 99%

Section: Significance and Innovationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Definitions for the Sonographic Features of Joints in Healthy Children

Roth

Jousse‐Joulin

Magni‐Manzoni

et al. 2014

Arthritis Care & Research

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“…Among the different applications of MSUS fields of validation, the pediatric field has been considered as one of the main areas. With the aim of improving the validity of MSUS for the diagnosis and management of synovitis in juvenile idiopathic arthritis (JIA), a new subtask force was included (4). This task force has developed a stepwise process: first, the development and validation, using the Delphi process, of definitions for US findings in healthy children and patients with JIA, and second, creating a consensus agreement on a precise scanning method in different age groups, with the collection of images showing the sonographic appearance of blood vessels in several joints, to be included in an atlas format.…”

Section: Introductionmentioning

confidence: 99%

Toward Standardized Musculoskeletal Ultrasound in Pediatric Rheumatology: Normal Age‐Related Ultrasound Findings

Collado

Vojinović

Nieto

et al. 2016

Arthritis Care & Research

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Objective. The Outcome Measures in Rheumatology Ultrasound Task Force has recently started to work on the validation and standardization of musculoskeletal ultrasound (MSUS) examination in children in order to improve its applicability to joint examination. Methods. This was a prospective multicenter study performed by 4 experts in pediatric MSUS, who independently collected representative images using predefined scanning procedures of 4 joints (knee, ankle, wrist, and second metacarpophalangeal joint) in different predefined age groups. Researchers were allowed to use their own settings (B-mode and Doppler) in order to get the best quality image and highest sensitivity for low blood flow. Images were evaluated for quality parameters and an atlas was created with the best images. An equipment comparative study was performed by a single examiner using 2 different types of machines. Results. Sixty-four healthy children were scanned. The quality of evaluated images, obtained by predefined scanning positions, was highly comparable among the examiners. The B-mode images clearly showed age-related variations of joint findings, while Doppler images showed the presence of blood flow, particularly within the epiphyseal cartilage of the children at a younger age. There was a high to good level of consistency between images obtained from the 2 different ultrasound machines. Conclusion. The study shows a systematic method for ultrasound examination of children at different age groups. Additionally, a baseline collection of images was developed, showing blood vessels in the joints examined. The present study could provide a framework for ongoing MSUS studies as well as for clinical practice in pediatric rheumatology.

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“…Over the last decade, the OMERACT MSUS group has assessed the metric properties of US in detecting and scoring potential endpoint in rheumatic diseases for clinical trials and practice [24][25][26][27][28]. The group has worked on validation of US-detected and graded tendon damage in RA [19,20], which is an essential component of the structural damage in this disease [19,20].…”

Section: Discussionmentioning

confidence: 99%

How does a cadaver model work for testing ultrasound diagnostic capability for rheumatic-like tendon damage?

et al. 2016

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(1); or complete tear (2). All 20 tendons were blindly and independently evaluated twice, over two rounds, by each of the three observers. Overall, technical performance was satisfactory for all items in the two rounds (all values over 2.9 in a Likert scale 1-5). Intraobserver and interobserver agreement for US grading of tendon damage was good (mean κ values 0.62 and 0.71, respectively), with greater reliability found in the TAT than the TPT. Concordance between US findings and experimental tendon lesions was acceptable (70-100 %), again greater for the TAT than for the TPT. A cadaver model with surgically created tendon damage can be useful in evaluating US metric properties of RA tendon lesions Keywords Tendon tear · Tendon damage · Ultrasound · Cadaver · Specimen Abstract To establish whether a cadaver model can serve as an effective surrogate for the detection of tendon damage characteristic of rheumatoid arthritis (RA). In addition, we evaluated intraobserver and interobserver agreement in the grading of RA-like tendon tears shown by US, as well as the concordance between the US findings and the surgically induced lesions in the cadaver model. RA-like tendon damage was surgically induced in the tibialis anterior tendon (TAT) and tibialis posterior tendon (TPT) of ten ankle/ foot fresh-frozen cadaveric specimens. Of the 20 tendons examined, six were randomly assigned a surgically induced partial tear; six a complete tear; and eight left undamaged. Three rheumatologists, experts in musculoskeletal US, assessed from 1 to 5 the quality of US imaging of the cadaveric models on a Likert scale. Tendons were then categorized as having either no damage, (0); partial tear, Electronic supplementary material The online version of this article

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The OMERACT Ultrasound Task Force — Status and Perspectives

Cited by 103 publications

References 19 publications

Definitions for the Sonographic Features of Joints in Healthy Children

Definitions for the Sonographic Features of Joints in Healthy Children

Toward Standardized Musculoskeletal Ultrasound in Pediatric Rheumatology: Normal Age‐Related Ultrasound Findings

How does a cadaver model work for testing ultrasound diagnostic capability for rheumatic-like tendon damage?

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