Assessing elementary lesions in gout by ultrasound: Results of an OMERACT patient-based agreement and reliability exercise

Lene Terslev, Marwin Gutierrez, Robin Christensen, P. Bálint, George A. Bruyn, Andrea Delle Sedie, Emilio Filippucci, Jesus Garrido, Hilde B. Hammer, Annamaria Iagnocco, David Kane, Gurjit S. Kaeley, Helen Keen, Peter Mandl, Esperanza Naredo, Carlos Pineda, Bernd Schicke, Ralf Thiele, Maria Antonietta D'Agostino, Wolfgang A. SchmidtIngrid Möller, David Bong, Marcin Szkudlarek, Eugenio De Miguel, Veronica Sharp, Christian Dejaco, Eugene Kissin, Petra Hanova, Frederique Gandjbakhch, Jane Freeston, Juhani Koski, Nanno Swen, Oscar Epis, Sibel Aydin, Viviana Ravagnani, Anthony Reginato, Richard J. Wakefield

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)2149-2154
Number of pages6
JournalJournal of Rheumatology
Volume42
Issue number11
DOIs
Publication statusPublished - Nov 1 2015

Fingerprint

Gout
Exercise
Metatarsophalangeal Joint
Exercise Test
Knee

Keywords

  • Exercise
  • Gout
  • Omeract
  • Reliability
  • Ultrasonography

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy

Cite this

Assessing elementary lesions in gout by ultrasound : Results of an OMERACT patient-based agreement and reliability exercise. / Terslev, Lene; Gutierrez, Marwin; Christensen, Robin; Bálint, P.; Bruyn, George A.; Delle Sedie, Andrea; Filippucci, Emilio; Garrido, Jesus; Hammer, Hilde B.; Iagnocco, Annamaria; Kane, David; Kaeley, Gurjit S.; Keen, Helen; Mandl, Peter; Naredo, Esperanza; Pineda, Carlos; Schicke, Bernd; Thiele, Ralf; D'Agostino, Maria Antonietta; Schmidt, Wolfgang A.; Möller, Ingrid; Bong, David; Szkudlarek, Marcin; De Miguel, Eugenio; Sharp, Veronica; Dejaco, Christian; Kissin, Eugene; Hanova, Petra; Gandjbakhch, Frederique; Freeston, Jane; Koski, Juhani; Swen, Nanno; Epis, Oscar; Aydin, Sibel; Ravagnani, Viviana; Reginato, Anthony; Wakefield, Richard J.

In: Journal of Rheumatology, Vol. 42, No. 11, 01.11.2015, p. 2149-2154.

Research output: Contribution to journalArticle

Terslev, L, Gutierrez, M, Christensen, R, Bálint, P, Bruyn, GA, Delle Sedie, A, Filippucci, E, Garrido, J, Hammer, HB, Iagnocco, A, Kane, D, Kaeley, GS, Keen, H, Mandl, P, Naredo, E, Pineda, C, Schicke, B, Thiele, R, D'Agostino, MA, Schmidt, WA, Möller, I, Bong, D, Szkudlarek, M, De Miguel, E, Sharp, V, Dejaco, C, Kissin, E, Hanova, P, Gandjbakhch, F, Freeston, J, Koski, J, Swen, N, Epis, O, Aydin, S, Ravagnani, V, Reginato, A & Wakefield, RJ 2015, 'Assessing elementary lesions in gout by ultrasound: Results of an OMERACT patient-based agreement and reliability exercise', Journal of Rheumatology, vol. 42, no. 11, pp. 2149-2154. https://doi.org/10.3899/jrheum.150366
Terslev, Lene ; Gutierrez, Marwin ; Christensen, Robin ; Bálint, P. ; Bruyn, George A. ; Delle Sedie, Andrea ; Filippucci, Emilio ; Garrido, Jesus ; Hammer, Hilde B. ; Iagnocco, Annamaria ; Kane, David ; Kaeley, Gurjit S. ; Keen, Helen ; Mandl, Peter ; Naredo, Esperanza ; Pineda, Carlos ; Schicke, Bernd ; Thiele, Ralf ; D'Agostino, Maria Antonietta ; Schmidt, Wolfgang A. ; Möller, Ingrid ; Bong, David ; Szkudlarek, Marcin ; De Miguel, Eugenio ; Sharp, Veronica ; Dejaco, Christian ; Kissin, Eugene ; Hanova, Petra ; Gandjbakhch, Frederique ; Freeston, Jane ; Koski, Juhani ; Swen, Nanno ; Epis, Oscar ; Aydin, Sibel ; Ravagnani, Viviana ; Reginato, Anthony ; Wakefield, Richard J. / Assessing elementary lesions in gout by ultrasound : Results of an OMERACT patient-based agreement and reliability exercise. In: Journal of Rheumatology. 2015 ; Vol. 42, No. 11. pp. 2149-2154.
@article{555a616a61594d3b87761719c2d52b5e,
title = "Assessing elementary lesions in gout by ultrasound: Results of an OMERACT patient-based agreement and reliability exercise",
abstract = "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.",
keywords = "Exercise, Gout, Omeract, Reliability, Ultrasonography",
author = "Lene Terslev and Marwin Gutierrez and Robin Christensen and P. B{\'a}lint and Bruyn, {George A.} and {Delle Sedie}, Andrea and Emilio Filippucci and Jesus Garrido and Hammer, {Hilde B.} and Annamaria Iagnocco and David Kane and Kaeley, {Gurjit S.} and Helen Keen and Peter Mandl and Esperanza Naredo and Carlos Pineda and Bernd Schicke and Ralf Thiele and D'Agostino, {Maria Antonietta} and Schmidt, {Wolfgang A.} and Ingrid M{\"o}ller and David Bong and Marcin Szkudlarek and {De Miguel}, Eugenio and Veronica Sharp and Christian Dejaco and Eugene Kissin and Petra Hanova and Frederique Gandjbakhch and Jane Freeston and Juhani Koski and Nanno Swen and Oscar Epis and Sibel Aydin and Viviana Ravagnani and Anthony Reginato and Wakefield, {Richard J.}",
year = "2015",
month = "11",
day = "1",
doi = "10.3899/jrheum.150366",
language = "English",
volume = "42",
pages = "2149--2154",
journal = "Journal of Rheumatology",
issn = "0315-162X",
publisher = "Journal of Rheumatology",
number = "11",

}

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 - Bálint, P.

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 - Möller, Ingrid

AU - Bong, David

AU - Szkudlarek, Marcin

AU - De Miguel, Eugenio

AU - Sharp, Veronica

AU - Dejaco, Christian

AU - Kissin, Eugene

AU - Hanova, Petra

AU - Gandjbakhch, Frederique

AU - Freeston, Jane

AU - Koski, Juhani

AU - Swen, Nanno

AU - Epis, Oscar

AU - Aydin, Sibel

AU - Ravagnani, Viviana

AU - Reginato, Anthony

AU - Wakefield, Richard J.

PY - 2015/11/1

Y1 - 2015/11/1

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.

KW - Exercise

KW - Gout

KW - Omeract

KW - Reliability

KW - Ultrasonography

UR - http://www.scopus.com/inward/record.url?scp=84946555499&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84946555499&partnerID=8YFLogxK

U2 - 10.3899/jrheum.150366

DO - 10.3899/jrheum.150366

M3 - Article

C2 - 26472419

AN - SCOPUS:84946555499

VL - 42

SP - 2149

EP - 2154

JO - Journal of Rheumatology

JF - Journal of Rheumatology

SN - 0315-162X

IS - 11

ER -