TY - JOUR
T1 - Assessing Elementary Lesions in Gout by Ultrasound
T2 - Results of an OMERACT Patient-based Agreement and Reliability Exercise
AU - Terslev, Lene
AU - Gutierrez, Marwin
AU - Christensen, Robin
AU - Balint, Peter V
AU - Bruyn, George A
AU - Delle Sedie, Andrea
AU - Filippucci, Emilio
AU - Garrido, Jesus
AU - Hammer, Hilde B
AU - Iagnocco, Annamaria
AU - Kane, David
AU - Kaeley, Gurjit S
AU - Keen, Helen
AU - Mandl, Peter
AU - Naredo, Esperanza
AU - Pineda, Carlos
AU - Schicke, Bernd
AU - Thiele, Ralf
AU - D'Agostino, Maria Antonietta
AU - Schmidt, Wolfgang A
AU - OMERACT US Gout Task Force
N1 - COPECARE
PY - 2015/11
Y1 - 2015/11
N2 - OBJECTIVE: To test the reliability of the consensus-based ultrasound (US) definitions of elementary gout lesions in patients.METHODS: Eight patients with microscopically proven gout were evaluated by 16 sonographers for signs of double contour (DC), aggregates, erosions, and tophi in the first metatarsophalangeal joint and the knee bilaterally. The patients were examined twice using B-mode US to test agreement and inter- and intraobserver reliability of the elementary components.RESULTS: The prevalence of the lesions were DC 52.8%, tophus 61.1%, aggregates 29.8%, and erosions 32.4%. The intraobserver reliability was good for all lesions except DC, where it was moderate. The best reliability per lesion was seen for tophus (κ 0.73, 95% CI 0.61-0.85) and lowest for DC (κ 0.53, 95% CI 0.38-0.67). The interobserver reliability was good for tophus and erosions, but fair to moderate for aggregates and DC, respectively. The best reliability was seen for erosions (κ 0.74, 95% CI 0.65-0.81) and lowest for aggregates (κ 0.21, 95% CI 0.04-0.37).CONCLUSION: This is the first step to test consensus-based US definitions on elementary lesions in patients with gout. High intraobserver reliability was found when applying the definition in patients on all elementary lesions while interobserver reliability was moderate to low. Further studies are needed to improve the interobserver reliability, particularly for DC and aggregates.
AB - OBJECTIVE: To test the reliability of the consensus-based ultrasound (US) definitions of elementary gout lesions in patients.METHODS: Eight patients with microscopically proven gout were evaluated by 16 sonographers for signs of double contour (DC), aggregates, erosions, and tophi in the first metatarsophalangeal joint and the knee bilaterally. The patients were examined twice using B-mode US to test agreement and inter- and intraobserver reliability of the elementary components.RESULTS: The prevalence of the lesions were DC 52.8%, tophus 61.1%, aggregates 29.8%, and erosions 32.4%. The intraobserver reliability was good for all lesions except DC, where it was moderate. The best reliability per lesion was seen for tophus (κ 0.73, 95% CI 0.61-0.85) and lowest for DC (κ 0.53, 95% CI 0.38-0.67). The interobserver reliability was good for tophus and erosions, but fair to moderate for aggregates and DC, respectively. The best reliability was seen for erosions (κ 0.74, 95% CI 0.65-0.81) and lowest for aggregates (κ 0.21, 95% CI 0.04-0.37).CONCLUSION: This is the first step to test consensus-based US definitions on elementary lesions in patients with gout. High intraobserver reliability was found when applying the definition in patients on all elementary lesions while interobserver reliability was moderate to low. Further studies are needed to improve the interobserver reliability, particularly for DC and aggregates.
U2 - 10.3899/jrheum.150366
DO - 10.3899/jrheum.150366
M3 - Journal article
C2 - 26472419
VL - 42
SP - 2149
EP - 2154
JO - Journal of Rheumatology
JF - Journal of Rheumatology
SN - 0315-162X
IS - 11
ER -