Ultrasonography of Inflammatory and Structural Lesions in Hand Osteoarthritis: An Outcome Measures in Rheumatology Agreement and Reliability Study

Alexander Mathiessen; Hilde B Hammer; Lene Terslev; Marion C Kortekaas; Maria A D'Agostino; Ida K Haugen; George A Bruyn; Georgios Filippou; Emilio Filippucci; Margreet Kloppenburg; Luana Mancarella; Peter Mandl; Ingrid Möller; Mohamed A Mortada; Esperanza Naredo; Andrea Delle Sedie; Joseph Sexton; Ruth Wittoek; Annamaria Iagnocco; Karen Ellegaard; OMERACT Ultrasound Working Group

doi:10.1002/acr.24734

Ultrasonography of Inflammatory and Structural Lesions in Hand Osteoarthritis: An Outcome Measures in Rheumatology Agreement and Reliability Study

Alexander Mathiessen, Hilde B Hammer, Lene Terslev, Marion C Kortekaas, Maria A D'Agostino, Ida K Haugen, George A Bruyn, Georgios Filippou, Emilio Filippucci, Margreet Kloppenburg, Luana Mancarella, Peter Mandl, Ingrid Möller, Mohamed A Mortada, Esperanza Naredo, Andrea Delle Sedie, Joseph Sexton, Ruth Wittoek, Annamaria Iagnocco, Karen EllegaardOMERACT Ultrasound Working Group

13 Citationer (Scopus)

Abstract

OBJECTIVE: To standardize and assess the reliability of ultrasonographic assessment of inflammatory and structural lesions in patients with hand osteoarthritis (OA).

METHODS: The Outcome Measures in Rheumatology Ultrasound Working Group selected synovial hypertrophy (SH), joint effusion (JE), and power Doppler (PD) signals as the main inflammatory lesions in hand OA, and suggested osteophytes in the scapho-trapezio-trapezoid (STT) and cartilage defects in the proximal interphalangeal (PIP) joints as novel additions to previous structural scoring systems. A complementary imaging atlas provided detailed examples of the scores. A reliability exercise of static images was performed for the inflammatory features, followed by a patient-based exercise with 6 sonographers testing inflammatory and structural features in 12 hand OA patients. We used Cohen's kappa for intrareader and Light's kappa for interreader reliability for all features except PD, in which prevalence-adjusted bias-adjusted kappa (PABAK) was applied. Percentage agreement was also assessed.

RESULTS: The web-based reliability exercise demonstrated substantial intra- and interreader reliability for all inflammatory features (κ > 0.64). In the patient-based exercise, intra- and interreader reliability, respectively, varied: SH κ = 0.73 and 0.45; JE κ = 0.70 and 0.55; PD PABAK = 0.90 and 0.88; PIP joint cartilage κ = 0.56 and 0.45; and STT osteophytes κ = 0.62 and 0.36. Percentage close agreement was high for all features (>85%).

CONCLUSION: With ultrasound, substantial to excellent intrareader reliability was found for inflammatory features of hand OA. Interreader reliability was moderate, but overall high close agreement between readers suggests that better reliability is achievable after further training. Assessment of osteophytes in the STT joint and cartilage in the PIP joints achieved less reliability and the latter is not endorsed.

Originalsprog	Engelsk
Tidsskrift	Arthritis Care & Research
Vol/bind	74
Udgave nummer	12
Sider (fra-til)	2005-2012
Antal sider	8
ISSN	2151-464X
DOI	https://doi.org/10.1002/acr.24734
Status	Udgivet - dec. 2022

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10.1002/acr.24734

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Mathiessen, A., Hammer, H. B., Terslev, L., Kortekaas, M. C., D'Agostino, M. A., Haugen, I. K., Bruyn, G. A., Filippou, G., Filippucci, E., Kloppenburg, M., Mancarella, L., Mandl, P., Möller, I., Mortada, M. A., Naredo, E., Delle Sedie, A., Sexton, J., Wittoek, R., Iagnocco, A., ... OMERACT Ultrasound Working Group (2022). Ultrasonography of Inflammatory and Structural Lesions in Hand Osteoarthritis: An Outcome Measures in Rheumatology Agreement and Reliability Study. Arthritis Care & Research, 74(12), 2005-2012. https://doi.org/10.1002/acr.24734

Mathiessen, A, Hammer, HB, Terslev, L, Kortekaas, MC, D'Agostino, MA, Haugen, IK, Bruyn, GA, Filippou, G, Filippucci, E, Kloppenburg, M, Mancarella, L, Mandl, P, Möller, I, Mortada, MA, Naredo, E, Delle Sedie, A, Sexton, J, Wittoek, R, Iagnocco, A, Ellegaard, K & OMERACT Ultrasound Working Group 2022, 'Ultrasonography of Inflammatory and Structural Lesions in Hand Osteoarthritis: An Outcome Measures in Rheumatology Agreement and Reliability Study', Arthritis Care & Research, bind 74, nr. 12, s. 2005-2012. https://doi.org/10.1002/acr.24734

@article{48ed3859f739492ba5db3e1cbafd13b2,

title = "Ultrasonography of Inflammatory and Structural Lesions in Hand Osteoarthritis: An Outcome Measures in Rheumatology Agreement and Reliability Study",

abstract = "OBJECTIVE: To standardize and assess the reliability of ultrasonographic assessment of inflammatory and structural lesions in patients with hand osteoarthritis (OA).METHODS: The Outcome Measures in Rheumatology Ultrasound Working Group selected synovial hypertrophy (SH), joint effusion (JE), and power Doppler (PD) signals as the main inflammatory lesions in hand OA, and suggested osteophytes in the scapho-trapezio-trapezoid (STT) and cartilage defects in the proximal interphalangeal (PIP) joints as novel additions to previous structural scoring systems. A complementary imaging atlas provided detailed examples of the scores. A reliability exercise of static images was performed for the inflammatory features, followed by a patient-based exercise with 6 sonographers testing inflammatory and structural features in 12 hand OA patients. We used Cohen's kappa for intrareader and Light's kappa for interreader reliability for all features except PD, in which prevalence-adjusted bias-adjusted kappa (PABAK) was applied. Percentage agreement was also assessed.RESULTS: The web-based reliability exercise demonstrated substantial intra- and interreader reliability for all inflammatory features (κ > 0.64). In the patient-based exercise, intra- and interreader reliability, respectively, varied: SH κ = 0.73 and 0.45; JE κ = 0.70 and 0.55; PD PABAK = 0.90 and 0.88; PIP joint cartilage κ = 0.56 and 0.45; and STT osteophytes κ = 0.62 and 0.36. Percentage close agreement was high for all features (>85%).CONCLUSION: With ultrasound, substantial to excellent intrareader reliability was found for inflammatory features of hand OA. Interreader reliability was moderate, but overall high close agreement between readers suggests that better reliability is achievable after further training. Assessment of osteophytes in the STT joint and cartilage in the PIP joints achieved less reliability and the latter is not endorsed.",

keywords = "Humans, Observer Variation, Osteoarthritis/diagnostic imaging, Osteophyte/diagnostic imaging, Outcome Assessment, Health Care, Reproducibility of Results, Rheumatology, Synovitis, Ultrasonography/methods",

author = "Alexander Mathiessen and Hammer, {Hilde B} and Lene Terslev and Kortekaas, {Marion C} and D'Agostino, {Maria A} and Haugen, {Ida K} and Bruyn, {George A} and Georgios Filippou and Emilio Filippucci and Margreet Kloppenburg and Luana Mancarella and Peter Mandl and Ingrid M{\"o}ller and Mortada, {Mohamed A} and Esperanza Naredo and {Delle Sedie}, Andrea and Joseph Sexton and Ruth Wittoek and Annamaria Iagnocco and Karen Ellegaard and {OMERACT Ultrasound Working Group}",

note = "COPECARE {\textcopyright} 2021 The Authors. Arthritis Care & Research published by Wiley Periodicals LLC on behalf of American College of Rheumatology.",

year = "2022",

month = dec,

doi = "10.1002/acr.24734",

language = "English",

volume = "74",

pages = "2005--2012",

journal = "Arthritis Care & Research",

issn = "2151-464X",

publisher = "JohnWiley & Sons, Inc",

number = "12",

}

TY - JOUR

T1 - Ultrasonography of Inflammatory and Structural Lesions in Hand Osteoarthritis

T2 - An Outcome Measures in Rheumatology Agreement and Reliability Study

AU - Mathiessen, Alexander

AU - Hammer, Hilde B

AU - Terslev, Lene

AU - Kortekaas, Marion C

AU - D'Agostino, Maria A

AU - Haugen, Ida K

AU - Bruyn, George A

AU - Filippou, Georgios

AU - Filippucci, Emilio

AU - Kloppenburg, Margreet

AU - Mancarella, Luana

AU - Mandl, Peter

AU - Möller, Ingrid

AU - Mortada, Mohamed A

AU - Naredo, Esperanza

AU - Delle Sedie, Andrea

AU - Sexton, Joseph

AU - Wittoek, Ruth

AU - Iagnocco, Annamaria

AU - Ellegaard, Karen

AU - OMERACT Ultrasound Working Group

PY - 2022/12

Y1 - 2022/12

N2 - OBJECTIVE: To standardize and assess the reliability of ultrasonographic assessment of inflammatory and structural lesions in patients with hand osteoarthritis (OA).METHODS: The Outcome Measures in Rheumatology Ultrasound Working Group selected synovial hypertrophy (SH), joint effusion (JE), and power Doppler (PD) signals as the main inflammatory lesions in hand OA, and suggested osteophytes in the scapho-trapezio-trapezoid (STT) and cartilage defects in the proximal interphalangeal (PIP) joints as novel additions to previous structural scoring systems. A complementary imaging atlas provided detailed examples of the scores. A reliability exercise of static images was performed for the inflammatory features, followed by a patient-based exercise with 6 sonographers testing inflammatory and structural features in 12 hand OA patients. We used Cohen's kappa for intrareader and Light's kappa for interreader reliability for all features except PD, in which prevalence-adjusted bias-adjusted kappa (PABAK) was applied. Percentage agreement was also assessed.RESULTS: The web-based reliability exercise demonstrated substantial intra- and interreader reliability for all inflammatory features (κ > 0.64). In the patient-based exercise, intra- and interreader reliability, respectively, varied: SH κ = 0.73 and 0.45; JE κ = 0.70 and 0.55; PD PABAK = 0.90 and 0.88; PIP joint cartilage κ = 0.56 and 0.45; and STT osteophytes κ = 0.62 and 0.36. Percentage close agreement was high for all features (>85%).CONCLUSION: With ultrasound, substantial to excellent intrareader reliability was found for inflammatory features of hand OA. Interreader reliability was moderate, but overall high close agreement between readers suggests that better reliability is achievable after further training. Assessment of osteophytes in the STT joint and cartilage in the PIP joints achieved less reliability and the latter is not endorsed.

AB - OBJECTIVE: To standardize and assess the reliability of ultrasonographic assessment of inflammatory and structural lesions in patients with hand osteoarthritis (OA).METHODS: The Outcome Measures in Rheumatology Ultrasound Working Group selected synovial hypertrophy (SH), joint effusion (JE), and power Doppler (PD) signals as the main inflammatory lesions in hand OA, and suggested osteophytes in the scapho-trapezio-trapezoid (STT) and cartilage defects in the proximal interphalangeal (PIP) joints as novel additions to previous structural scoring systems. A complementary imaging atlas provided detailed examples of the scores. A reliability exercise of static images was performed for the inflammatory features, followed by a patient-based exercise with 6 sonographers testing inflammatory and structural features in 12 hand OA patients. We used Cohen's kappa for intrareader and Light's kappa for interreader reliability for all features except PD, in which prevalence-adjusted bias-adjusted kappa (PABAK) was applied. Percentage agreement was also assessed.RESULTS: The web-based reliability exercise demonstrated substantial intra- and interreader reliability for all inflammatory features (κ > 0.64). In the patient-based exercise, intra- and interreader reliability, respectively, varied: SH κ = 0.73 and 0.45; JE κ = 0.70 and 0.55; PD PABAK = 0.90 and 0.88; PIP joint cartilage κ = 0.56 and 0.45; and STT osteophytes κ = 0.62 and 0.36. Percentage close agreement was high for all features (>85%).CONCLUSION: With ultrasound, substantial to excellent intrareader reliability was found for inflammatory features of hand OA. Interreader reliability was moderate, but overall high close agreement between readers suggests that better reliability is achievable after further training. Assessment of osteophytes in the STT joint and cartilage in the PIP joints achieved less reliability and the latter is not endorsed.

KW - Humans

KW - Observer Variation

KW - Osteoarthritis/diagnostic imaging

KW - Osteophyte/diagnostic imaging

KW - Outcome Assessment, Health Care

KW - Reproducibility of Results

KW - Rheumatology

KW - Synovitis

KW - Ultrasonography/methods

U2 - 10.1002/acr.24734

DO - 10.1002/acr.24734

M3 - Journal article

C2 - 34137211

SN - 2151-464X

VL - 74

SP - 2005

EP - 2012

JO - Arthritis Care & Research

JF - Arthritis Care & Research

IS - 12

ER -

Ultrasonography of Inflammatory and Structural Lesions in Hand Osteoarthritis: An Outcome Measures in Rheumatology Agreement and Reliability Study

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