Reliability of ultrasonography to detect inflammatory lesions and structural damage in juvenile idiopathic arthritis
Background Musculoskeletal Ultrasonography (MSUS) is an important tool for the clinical assessment in Juvenile Idiopathic Arthritis (JIA). The objective of this study was to evaluate the reliability of MSUS to detect elementary lesions: synovitis, tenosynovitis, cartilage damage and bone erosions i...
| Autores principales: | , , , , , , , , |
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| Formato: | Artículo |
| Lenguaje: | inglés |
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University of Chicago
2018
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| Materias: | |
| Acceso en línea: | http://eprints.uanl.mx/16100/1/72.pdf |
| _version_ | 1824414497938341888 |
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| author | Ventura Ríos, Lucio Faugier, Enrique Barzola, Laura De la Cruz Becerra, L. B. Sánchez Bringas, Guadalupe Rodríguez García, Andrés Maldonado, Rocío Roth, Johannes Hernández Díaz, Cristina |
| author_facet | Ventura Ríos, Lucio Faugier, Enrique Barzola, Laura De la Cruz Becerra, L. B. Sánchez Bringas, Guadalupe Rodríguez García, Andrés Maldonado, Rocío Roth, Johannes Hernández Díaz, Cristina |
| author_sort | Ventura Ríos, Lucio |
| collection | Repositorio Institucional |
| description | Background
Musculoskeletal Ultrasonography (MSUS) is an important tool for the clinical assessment in Juvenile Idiopathic Arthritis (JIA). The objective of this study was to evaluate the reliability of MSUS to detect elementary lesions: synovitis, tenosynovitis, cartilage damage and bone erosions in the wrist and metacarpal (MCP) joints of patients with JIA.
Methods
Thirty children in various subgroups of JIA according to ILAR criteria, were included in this cross-sectional study. Clinical data including painful, swollen and limited joints were recorded. Five rheumatologist ultrasonographers, blinded to the clinical evaluation, evaluated the presence of elementary lesions in the wrist and MCP 2 and 3 joints bilaterally. The synovitis was graded in B-Mode and Power Doppler (PD). In addition to descriptive statistics intra- and inter-observer reliability was calculated using Cohen’s kappa according to Landis and Koch.
Results
US detected more synovitis than the clinical examination (62% vs 28%, 30% vs 23% and 22% vs 17% in the wrist, second and third MCP joints respectively). The intra-observer concordance for synovitis in all joints was excellent in B-Mode (k 0.84 .63–1.0 p = 0.001), except for MCP 2, where it was good (0.61, IC 95% .34–89, p = 0.001). For both modalities (PD, B-Mode) tenosynovitis, cartilage damage and bone erosions it was also excellent. Regarding synovitis grading the concordance was excellent for all grades (0.83–1.0, IC 95% 0.51.1.0, p = 0.001), except for grade 1 where it was good (0.61, IC 95% 0.43–.83, p = 0.001). Reliability inter-observer for grayscale synovitis (0.67–0.95, IC 95% 0.67–1.0, p = 0.001), tenosynovitis grayscale (0.89, IC 95% 0.78–0.99, p.001), damage cartilage (0.89, IC 95% 0.78–0.99, p = 0.001), PD (0.66, IC 95% 0.39–1.0, p = 0.001). The concordance for grading synovitis was excellent, but for grayscale grade 1 and 2 (.66, IC 95% .53–.74, p = 0.007) and PD grade 1 and 2 (0.63, IC 95% .58–.91, p = 004) was good.
Conclusions
The intra- and inter-observer reliability of MSUS for inflammatory and structural lesions is good to excellent for the wrist and MCP in patients with JIA.
Keywords: Reliability, Musculoskeletal ultrasound, Juvenile idiopathic arthritis |
| format | Article |
| id | eprints-16100 |
| institution | UANL |
| language | English |
| publishDate | 2018 |
| publisher | University of Chicago |
| record_format | eprints |
| spelling | eprints-161002020-06-26T12:42:36Z http://eprints.uanl.mx/16100/ Reliability of ultrasonography to detect inflammatory lesions and structural damage in juvenile idiopathic arthritis Ventura Ríos, Lucio Faugier, Enrique Barzola, Laura De la Cruz Becerra, L. B. Sánchez Bringas, Guadalupe Rodríguez García, Andrés Maldonado, Rocío Roth, Johannes Hernández Díaz, Cristina RJ Pediatría Background Musculoskeletal Ultrasonography (MSUS) is an important tool for the clinical assessment in Juvenile Idiopathic Arthritis (JIA). The objective of this study was to evaluate the reliability of MSUS to detect elementary lesions: synovitis, tenosynovitis, cartilage damage and bone erosions in the wrist and metacarpal (MCP) joints of patients with JIA. Methods Thirty children in various subgroups of JIA according to ILAR criteria, were included in this cross-sectional study. Clinical data including painful, swollen and limited joints were recorded. Five rheumatologist ultrasonographers, blinded to the clinical evaluation, evaluated the presence of elementary lesions in the wrist and MCP 2 and 3 joints bilaterally. The synovitis was graded in B-Mode and Power Doppler (PD). In addition to descriptive statistics intra- and inter-observer reliability was calculated using Cohen’s kappa according to Landis and Koch. Results US detected more synovitis than the clinical examination (62% vs 28%, 30% vs 23% and 22% vs 17% in the wrist, second and third MCP joints respectively). The intra-observer concordance for synovitis in all joints was excellent in B-Mode (k 0.84 .63–1.0 p = 0.001), except for MCP 2, where it was good (0.61, IC 95% .34–89, p = 0.001). For both modalities (PD, B-Mode) tenosynovitis, cartilage damage and bone erosions it was also excellent. Regarding synovitis grading the concordance was excellent for all grades (0.83–1.0, IC 95% 0.51.1.0, p = 0.001), except for grade 1 where it was good (0.61, IC 95% 0.43–.83, p = 0.001). Reliability inter-observer for grayscale synovitis (0.67–0.95, IC 95% 0.67–1.0, p = 0.001), tenosynovitis grayscale (0.89, IC 95% 0.78–0.99, p.001), damage cartilage (0.89, IC 95% 0.78–0.99, p = 0.001), PD (0.66, IC 95% 0.39–1.0, p = 0.001). The concordance for grading synovitis was excellent, but for grayscale grade 1 and 2 (.66, IC 95% .53–.74, p = 0.007) and PD grade 1 and 2 (0.63, IC 95% .58–.91, p = 004) was good. Conclusions The intra- and inter-observer reliability of MSUS for inflammatory and structural lesions is good to excellent for the wrist and MCP in patients with JIA. Keywords: Reliability, Musculoskeletal ultrasound, Juvenile idiopathic arthritis University of Chicago 2018 Article PeerReviewed text en cc_by_nc_nd http://eprints.uanl.mx/16100/1/72.pdf http://eprints.uanl.mx/16100/1.haspreviewThumbnailVersion/72.pdf Ventura Ríos, Lucio y Faugier, Enrique y Barzola, Laura y De la Cruz Becerra, L. B. y Sánchez Bringas, Guadalupe y Rodríguez García, Andrés y Maldonado, Rocío y Roth, Johannes y Hernández Díaz, Cristina (2018) Reliability of ultrasonography to detect inflammatory lesions and structural damage in juvenile idiopathic arthritis. Pediatric Rheumatology, 16 (1). pp. 1-8. ISSN 1546-0096 http://doi.org/10.1186/s12969-018-0275-4 doi:10.1186/s12969-018-0275-4 |
| spellingShingle | RJ Pediatría Ventura Ríos, Lucio Faugier, Enrique Barzola, Laura De la Cruz Becerra, L. B. Sánchez Bringas, Guadalupe Rodríguez García, Andrés Maldonado, Rocío Roth, Johannes Hernández Díaz, Cristina Reliability of ultrasonography to detect inflammatory lesions and structural damage in juvenile idiopathic arthritis |
| thumbnail | https://rediab.uanl.mx/themes/sandal5/images/online.png |
| title | Reliability of ultrasonography to detect inflammatory lesions and structural damage in juvenile idiopathic arthritis |
| title_full | Reliability of ultrasonography to detect inflammatory lesions and structural damage in juvenile idiopathic arthritis |
| title_fullStr | Reliability of ultrasonography to detect inflammatory lesions and structural damage in juvenile idiopathic arthritis |
| title_full_unstemmed | Reliability of ultrasonography to detect inflammatory lesions and structural damage in juvenile idiopathic arthritis |
| title_short | Reliability of ultrasonography to detect inflammatory lesions and structural damage in juvenile idiopathic arthritis |
| title_sort | reliability of ultrasonography to detect inflammatory lesions and structural damage in juvenile idiopathic arthritis |
| topic | RJ Pediatría |
| url | http://eprints.uanl.mx/16100/1/72.pdf |
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