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Assessing Vasculitis in Giant Cell Arteritis by Ultrasound: Results of OMERACT Patient-based Reliability Exercises

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review


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  • Valentin S Schäfer
  • Stavros Chrysidis
  • Christian Dejaco
  • Christina Duftner
  • Annamaria Iagnocco
  • George A Bruyn
  • Greta Carrara
  • Maria Antonietta D'Agostino
  • Eugenio De Miguel
  • Andreas P Diamantopoulos
  • Ulrich Fredberg
  • Wolfgang Hartung
  • Alojzija Hocevar
  • Aaron Juche
  • Tanaz A Kermani
  • Matthew J Koster
  • Tove Lorenzen
  • Pierluigi Macchioni
  • Marcin Milchert
  • Uffe Møller Døhn
  • Chetan Mukhtyar
  • Cristina Ponte
  • Sofia Ramiro
  • Carlo A Scirè
  • Lene Terslev
  • Kenneth J Warrington
  • Bhaskar Dasgupta
  • Wolfgang A Schmidt
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OBJECTIVE: To test the reliability of Outcome Measures in Rheumatology Clinical Trials (OMERACT) consensus-based ultrasound definitions for normal and vasculitic temporal and axillary arteries in patients with giant cell arteritis (GCA) and in controls.

METHODS: A preliminary 1-day meeting and a full 3-day meeting fulfilling OMERACT Ultrasound Group guidelines were held. Temporal and axillary arteries were examined at 2 timepoints by 12 sonographers on 4 patients with GCA and 2 controls. The aim was to test inter- and intrareader reliability for normal findings, halo sign, and compression sign. In both meetings, patients had established GCA. Pathology was more recent in the full meeting, which was preceded by 6 h of training. Scanning time was 15-20 min instead of 10-13 min.

RESULTS: In the preliminary exercise, interreader reliabilities were fair to moderate for the overall diagnosis of GCA (Light κ 0.29-0.51), and poor to fair for identifying vasculitis in the respective anatomical segments (Light κ 0.02-0.46). Intrareader reliabilities were moderate (Cohen κ 0.32-0.64). In the main exercise, interreader reliability was good to excellent (Light κ 0.76-0.86) for the overall diagnosis of GCA, and moderate to good (Light κ 0.46-0.71) for identifying vasculitis in the respective anatomical segments. Intrareader reliability was excellent for diagnosis of GCA (Cohen κ 0.91) and good (Cohen κ 0.71-0.80) for the anatomical segments.

CONCLUSION: OMERACT-derived definitions of halo and compression signs of temporal and axillary arteries are reliable in recent-onset GCA if experienced sonographers (> 300 examinations) have 15-20 min for a standardized examination with prior training and apply > 15 MHz probes.

TidsskriftJournal of Rheumatology
Udgave nummer9
Sider (fra-til)1289-1295
Antal sider7
StatusUdgivet - aug. 2018

ID: 56071458