Document Detail


Reproducibility of musculoskeletal ultrasound for determining monosodium urate deposition: concordance between readers.
MedLine Citation:
PMID:  21702086     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Criteria for sonographic diagnosis of monosodium urate (MSU) crystal deposition have been developed, but the interreader reproducibility of this modality is not well established. We therefore assessed agreement using a systematic approach.
METHODS: Fifty male subjects ages 55-85 years were recruited during primary care visits to an urban Veterans Affairs hospital, and were assessed by musculoskeletal ultrasound (US) of the knees and first metatarsophalangeal (MTP) joints to evaluate for the double contour sign and tophi as evidence of MSU crystal deposition. Images were read by 2 blinded rheumatologists trained in musculoskeletal US, and the degree of concordance was determined for individual subjects, total joints, femoral articular cartilage (FAC), and first MTP joints. Subjects were further categorized into 3 diagnostic groups: gout, asymptomatic hyperuricemia (no gout, serum uric acid [UA] ≥6.9 mg/dl), and controls (no gout, serum UA ≤6.8 mg/dl), and reader concordance within these 3 groups was assessed.
RESULTS: We observed almost perfect agreement between readers for 1) individual subjects (yes/no; n = 50, 100% agreement, κ = 1.000), 2) total joints (n = 200, 99% agreement, κ = 0.942), 3) FAC (n = 100, 99% agreement, κ = 0.942), and 4) first MTP joints (n = 100, 99% agreement, κ = 0.942). Furthermore, findings by side (right/left) and diagnostic group (gout, asymptomatic hyperuricemia, control) showed substantial to almost perfect concordance for all measures. MSU deposition was seen most commonly in gout patients, and deposition was also seen in some subjects with asymptomatic hyperuricemia, but in only 1 control.
CONCLUSION: Musculoskeletal US is reliable for detecting MSU deposition in FAC and first MTP joints in gout and asymptomatic hyperuricemia.
Authors:
Rennie G Howard; Michael H Pillinger; Soterios Gyftopoulos; Ralf G Thiele; Christopher J Swearingen; Jonathan Samuels
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Arthritis care & research     Volume:  63     ISSN:  2151-4658     ISO Abbreviation:  Arthritis Care Res (Hoboken)     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-09-28     Completed Date:  2011-11-28     Revised Date:  2012-05-10    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1456-62     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 by the American College of Rheumatology.
Affiliation:
New York University Langone Medical Center, New York University Hospital for Joint Diseases, and New York Harbor VA Health Care System New York Campus, New York, USA. rennie.howard@nyumc.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Asymptomatic Diseases
Crystallization
Gout / etiology,  metabolism,  ultrasonography*
Hospitals, Veterans
Humans
Hyperuricemia / complications,  metabolism,  ultrasonography*
Knee Joint / chemistry,  ultrasonography*
Male
Metatarsophalangeal Joint / chemistry,  ultrasonography*
Middle Aged
New York City
Observer Variation
Predictive Value of Tests
Reproducibility of Results
Uric Acid / analysis*
Grant Support
ID/Acronym/Agency:
1-UL1-RR029893/RR/NCRR NIH HHS; 5T32AR007176/AR/NIAMS NIH HHS; T32 AR007176-36/AR/NIAMS NIH HHS
Chemical
Reg. No./Substance:
69-93-2/Uric Acid
Comments/Corrections
Comment In:
Arthritis Care Res (Hoboken). 2012 May;64(5):794-5; author reply 795-6   [PMID:  22223549 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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