TY - JOUR

T1 - Criterion validity of ultrasound in the identification of calcium pyrophosphate crystal deposits at the knee: an OMERACT ultrasound study

AU - Filippou, Georgios

AU - Scanu, Anna

AU - Adinolfi, Antonella

AU - Toscano, Carmela

AU - Gambera, Dario

AU - Largo, Raquel

AU - Naredo, Esperanza

AU - Calvo, Emilio

AU - Herrero-Beaumont, Gabriel

AU - Zufferey, Pascal

AU - Bonjour, Christel Madelaine

AU - MacCarter, Daryl K

AU - Makman, Stanley

AU - Weber, Zachary

AU - Figus, Fabiana

AU - Möller, Ingrid

AU - Gutierrez, Marwin

AU - Pineda, Carlos

AU - Clavijo Cornejo, Denise

AU - Garcia, Hector

AU - Ilizaliturri, Victor

AU - Mendoza Torres, Jaime

AU - Pichardo, Raul

AU - Rodriguez Delgado, Luis Carlos

AU - Filippucci, Emilio

AU - Cipolletta, Edoardo

AU - Serban, Teodora

AU - Cirstoiu, Catalin

AU - Vreju, Florentin Ananu

AU - Grecu, Dan

AU - Mouterde, Gaël

AU - Govoni, Marcello

AU - Punzi, Leonardo

AU - Damjanov, Nemanja S

AU - Keen, Helen Isobel

AU - Bruyn, George Aw

AU - Terslev, Lene

AU - D'Agostino, Maria-Antonietta

AU - Scirè, Carlo Alberto

AU - Iagnocco, Annamaria

N1 - © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2021/2

Y1 - 2021/2

N2 - OBJECTIVE: To evaluate the discriminatory ability of ultrasound in calcium pyrophosphate deposition disease (CPPD), using microscopic analysis of menisci and knee hyaline cartilage (HC) as reference standard.METHODS: Consecutive patients scheduled for knee replacement surgery, due to osteoarthritis (OA), were enrolled. Each patient underwent ultrasound examination of the menisci and HC of the knee, scoring each site for presence/absence of CPPD. Ultrasound signs of inflammation (effusion, synovial proliferation and power Doppler) were assessed semiquantitatively (0-3). The menisci and condyles, retrieved during surgery, were examined microscopically by optical light microscopy and by compensated polarised microscopy. CPPs were scored as present/absent in six different samples from the surface and from the internal part of menisci and cartilage. Ultrasound and microscopic analysis were performed by different operators, blinded to each other's findings.RESULTS: 11 researchers from seven countries participated in the study. Of 101 enrolled patients, 68 were included in the analysis. In 38 patients, the surgical specimens were insufficient. The overall diagnostic accuracy of ultrasound for CPPD was of 75%-sensitivity of 91% (range 71%-87% in single sites) and specificity of 59% (range 68%-92%). The best sensitivity and specificity were obtained by assessing in combination by ultrasound the medial meniscus and the medial condyle HC (88% and 76%, respectively). No differences were found between patients with and without CPPD regarding ultrasound signs of inflammation.CONCLUSION: Ultrasound demonstrated to be an accurate tool for discriminating CPPD. No differences were found between patents with OA alone and CPPD plus OA regarding inflammation.

AB - OBJECTIVE: To evaluate the discriminatory ability of ultrasound in calcium pyrophosphate deposition disease (CPPD), using microscopic analysis of menisci and knee hyaline cartilage (HC) as reference standard.METHODS: Consecutive patients scheduled for knee replacement surgery, due to osteoarthritis (OA), were enrolled. Each patient underwent ultrasound examination of the menisci and HC of the knee, scoring each site for presence/absence of CPPD. Ultrasound signs of inflammation (effusion, synovial proliferation and power Doppler) were assessed semiquantitatively (0-3). The menisci and condyles, retrieved during surgery, were examined microscopically by optical light microscopy and by compensated polarised microscopy. CPPs were scored as present/absent in six different samples from the surface and from the internal part of menisci and cartilage. Ultrasound and microscopic analysis were performed by different operators, blinded to each other's findings.RESULTS: 11 researchers from seven countries participated in the study. Of 101 enrolled patients, 68 were included in the analysis. In 38 patients, the surgical specimens were insufficient. The overall diagnostic accuracy of ultrasound for CPPD was of 75%-sensitivity of 91% (range 71%-87% in single sites) and specificity of 59% (range 68%-92%). The best sensitivity and specificity were obtained by assessing in combination by ultrasound the medial meniscus and the medial condyle HC (88% and 76%, respectively). No differences were found between patients with and without CPPD regarding ultrasound signs of inflammation.CONCLUSION: Ultrasound demonstrated to be an accurate tool for discriminating CPPD. No differences were found between patents with OA alone and CPPD plus OA regarding inflammation.

U2 - 10.1136/annrheumdis-2020-217998

DO - 10.1136/annrheumdis-2020-217998

M3 - Journal article

C2 - 32988839

VL - 80

SP - 261

EP - 267

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 2

ER -