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Inter-observer reliability of ultrasound detection of tendon abnormalities at the wrist and ankle in patients with rheumatoid arthritis.
MedLine Citation:
PMID:  21266445     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective. To assess inter-observer reliability in US detection of tendon inflammatory and structural changes at wrists and ankles in RA patients. Methods. Fourteen consecutive RA patients underwent bilateral US assessment of the extensor carpi ulnaris (ECUT) and tibialis posterior tendons (TPTs) by two blinded rheumatologists, with different level of experience in musculoskeletal (MS) US. Grey scale and power Doppler (PD) US assessment was focused on detection of tenosynovitis, tenosynovial and intra-tendon PD signal and structural lesions (i.e. tendinosis, tendon erosion, partial or total rupture). Results. The frequency of US findings detected by Investigator 1 was 28.6% for inflammatory changes and 51.8% for structural damage changes while Investigator 2 detected 34 and 53.6% for the corresponding abnormalities. A high overall agreement (82.7%) was found for inflammatory pathology and 89.7% for structural lesions in all tendons. Mean kappa (κ) values for all tendons and pathology was moderate (κ = 0.42), with fair level of agreement for the wrist region (0.27-0.34) and moderate to good values for the ankle region (κ = 0.47-0.62). Subclinical abnormalities were detected in 37.5% of the tendons by Investigator 1 and 28.6% of the tendons by Investigator 2. Conclusions. MSUS showed high overall agreement and fair to moderate inter-observer κ-values between investigators with different levels of experience in detection of tendon pathology at the wrist and ankle in RA patients. Further standardization of scanning method and pathology definitions may improve MSUS reproducibility.
Authors:
Mihaela C Micu; Sara Serra; Daniela Fodor; Manuel Crespo; Esperanza Naredo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-25
Journal Detail:
Title:  Rheumatology (Oxford, England)     Volume:  -     ISSN:  1462-0332     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883501     Medline TA:  Rheumatology (Oxford)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Rehabilitation II Department, Division of Rheumatology, Rehabilitation Clinical Hospital, Cluj-Napoca, Romania, Rheumatology Department, Hospitais da Universidade Coimbra, Portugal, Internal Medicine Department, Medicala II Clinic, University of Medicine and Pharmacy 'Iuliu Hatieganu', Cluj-Napoca, Romania and Department of Rheumatology, Hospital Universitario Severo Ochoa, Madrid, Spain.
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