Interobserver reliability in musculoskeletal ultrasonography

Results from a "Teach the Teachers" rheumatologist course

E. Naredo, I. Möller, C. Moragues, J. J. De Agustín, A. K. Scheel, W. Grassi, E. De Miguel, M. Backhaus, P. Bálint, G. A W Bruyn, M. A. D'Agostino, E. Filippucci, A. Iagnocco, D. Kane, J. M. Koski, L. Mayordomo, W. A. Schmidt, W. A A Swen, M. Szkudlarek, L. Terslev & 4 others S. Torp-Pedersen, J. Uson, R. J. Wakefield, C. Werner

Research output: Contribution to journalArticle

166 Citations (Scopus)

Abstract

Objective: To assess the interobserver reliability of the main periarticular and intra-articular ultrasonographic pathologies and to establish the principal disagreements on scanning technique and diagnostic criteria between a group of experts in musculoskeletal ultrasonography. Methods: The shoulder, wrist/hand, ankle/foot, or knee of 24 patients with rheumatic diseases were evaluated by 23 musculoskeletal ultrasound experts from different European countries randomly assigned to six groups. The participants did not reach consensus on scanning method or diagnostic criteria before the investigation. They were unaware of the patients' clinical and imaging data. The experts from each group undertook a blinded ultrasound examination of the four anatomical regions. The ultrasound investigation included the presence/absence of joint effusion/synovitis, bony cortex abnormalities, tenosynovitis, tendon lesions, bursitis, and power Doppler signal. Afterwards they compared the ultrasound findings and re-examined the patients together while discussing their results. Results: Overall agreements were 91% for joint effusion/synovitis and tendon lesions, 87% for cortical abnormalities, 84% for tenosynovitis, 83.5% for bursitis, and 83% for power Doppler signal; κ values were good for the wrist/hand and knee (0.61 and 0.60) and fair for the shoulder and ankle/foot (0.50 and 0.54). The principal differences in scanning method and diagnostic criteria between experts were related to dynamic examination, definition of tendon lesions, and pathological v physiological fluid within joints, tendon sheaths, and bursae. Conclusions: Musculoskeletal ultrasound has a moderate to good interobserver reliability. Further consensus on standardisation of scanning technique and diagnostic criteria is necessary to improve musculoskeletal ultrasonography reproducibility.

Original languageEnglish
Pages (from-to)14-19
Number of pages6
JournalAnnals of the Rheumatic Diseases
Volume65
Issue number1
DOIs
Publication statusPublished - Jan 2006

Fingerprint

Ultrasonography
Tendons
Joints
Ultrasonics
Tenosynovitis
Bursitis
Synovitis
Scanning
Wrist
Ankle
Foot
Knee
Hand
Rheumatic Diseases
Pathology
Standardization
Rheumatologists
Imaging techniques
Fluids

ASJC Scopus subject areas

  • Rheumatology
  • Immunology

Cite this

Naredo, E., Möller, I., Moragues, C., De Agustín, J. J., Scheel, A. K., Grassi, W., ... Werner, C. (2006). Interobserver reliability in musculoskeletal ultrasonography: Results from a "Teach the Teachers" rheumatologist course. Annals of the Rheumatic Diseases, 65(1), 14-19. https://doi.org/10.1136/ard.2005.037382

Interobserver reliability in musculoskeletal ultrasonography : Results from a "Teach the Teachers" rheumatologist course. / Naredo, E.; Möller, I.; Moragues, C.; De Agustín, J. J.; Scheel, A. K.; Grassi, W.; De Miguel, E.; Backhaus, M.; Bálint, P.; Bruyn, G. A W; D'Agostino, M. A.; Filippucci, E.; Iagnocco, A.; Kane, D.; Koski, J. M.; Mayordomo, L.; Schmidt, W. A.; Swen, W. A A; Szkudlarek, M.; Terslev, L.; Torp-Pedersen, S.; Uson, J.; Wakefield, R. J.; Werner, C.

In: Annals of the Rheumatic Diseases, Vol. 65, No. 1, 01.2006, p. 14-19.

Research output: Contribution to journalArticle

Naredo, E, Möller, I, Moragues, C, De Agustín, JJ, Scheel, AK, Grassi, W, De Miguel, E, Backhaus, M, Bálint, P, Bruyn, GAW, D'Agostino, MA, Filippucci, E, Iagnocco, A, Kane, D, Koski, JM, Mayordomo, L, Schmidt, WA, Swen, WAA, Szkudlarek, M, Terslev, L, Torp-Pedersen, S, Uson, J, Wakefield, RJ & Werner, C 2006, 'Interobserver reliability in musculoskeletal ultrasonography: Results from a "Teach the Teachers" rheumatologist course', Annals of the Rheumatic Diseases, vol. 65, no. 1, pp. 14-19. https://doi.org/10.1136/ard.2005.037382
Naredo, E. ; Möller, I. ; Moragues, C. ; De Agustín, J. J. ; Scheel, A. K. ; Grassi, W. ; De Miguel, E. ; Backhaus, M. ; Bálint, P. ; Bruyn, G. A W ; D'Agostino, M. A. ; Filippucci, E. ; Iagnocco, A. ; Kane, D. ; Koski, J. M. ; Mayordomo, L. ; Schmidt, W. A. ; Swen, W. A A ; Szkudlarek, M. ; Terslev, L. ; Torp-Pedersen, S. ; Uson, J. ; Wakefield, R. J. ; Werner, C. / Interobserver reliability in musculoskeletal ultrasonography : Results from a "Teach the Teachers" rheumatologist course. In: Annals of the Rheumatic Diseases. 2006 ; Vol. 65, No. 1. pp. 14-19.
@article{500186b2b2cf49e99c0da19b758f9959,
title = "Interobserver reliability in musculoskeletal ultrasonography: Results from a {"}Teach the Teachers{"} rheumatologist course",
abstract = "Objective: To assess the interobserver reliability of the main periarticular and intra-articular ultrasonographic pathologies and to establish the principal disagreements on scanning technique and diagnostic criteria between a group of experts in musculoskeletal ultrasonography. Methods: The shoulder, wrist/hand, ankle/foot, or knee of 24 patients with rheumatic diseases were evaluated by 23 musculoskeletal ultrasound experts from different European countries randomly assigned to six groups. The participants did not reach consensus on scanning method or diagnostic criteria before the investigation. They were unaware of the patients' clinical and imaging data. The experts from each group undertook a blinded ultrasound examination of the four anatomical regions. The ultrasound investigation included the presence/absence of joint effusion/synovitis, bony cortex abnormalities, tenosynovitis, tendon lesions, bursitis, and power Doppler signal. Afterwards they compared the ultrasound findings and re-examined the patients together while discussing their results. Results: Overall agreements were 91{\%} for joint effusion/synovitis and tendon lesions, 87{\%} for cortical abnormalities, 84{\%} for tenosynovitis, 83.5{\%} for bursitis, and 83{\%} for power Doppler signal; κ values were good for the wrist/hand and knee (0.61 and 0.60) and fair for the shoulder and ankle/foot (0.50 and 0.54). The principal differences in scanning method and diagnostic criteria between experts were related to dynamic examination, definition of tendon lesions, and pathological v physiological fluid within joints, tendon sheaths, and bursae. Conclusions: Musculoskeletal ultrasound has a moderate to good interobserver reliability. Further consensus on standardisation of scanning technique and diagnostic criteria is necessary to improve musculoskeletal ultrasonography reproducibility.",
author = "E. Naredo and I. M{\"o}ller and C. Moragues and {De Agust{\'i}n}, {J. J.} and Scheel, {A. K.} and W. Grassi and {De Miguel}, E. and M. Backhaus and P. B{\'a}lint and Bruyn, {G. A W} and D'Agostino, {M. A.} and E. Filippucci and A. Iagnocco and D. Kane and Koski, {J. M.} and L. Mayordomo and Schmidt, {W. A.} and Swen, {W. A A} and M. Szkudlarek and L. Terslev and S. Torp-Pedersen and J. Uson and Wakefield, {R. J.} and C. Werner",
year = "2006",
month = "1",
doi = "10.1136/ard.2005.037382",
language = "English",
volume = "65",
pages = "14--19",
journal = "Annals of the Rheumatic Diseases",
issn = "0003-4967",
publisher = "BMJ Publishing Group",
number = "1",

}

TY - JOUR

T1 - Interobserver reliability in musculoskeletal ultrasonography

T2 - Results from a "Teach the Teachers" rheumatologist course

AU - Naredo, E.

AU - Möller, I.

AU - Moragues, C.

AU - De Agustín, J. J.

AU - Scheel, A. K.

AU - Grassi, W.

AU - De Miguel, E.

AU - Backhaus, M.

AU - Bálint, P.

AU - Bruyn, G. A W

AU - D'Agostino, M. A.

AU - Filippucci, E.

AU - Iagnocco, A.

AU - Kane, D.

AU - Koski, J. M.

AU - Mayordomo, L.

AU - Schmidt, W. A.

AU - Swen, W. A A

AU - Szkudlarek, M.

AU - Terslev, L.

AU - Torp-Pedersen, S.

AU - Uson, J.

AU - Wakefield, R. J.

AU - Werner, C.

PY - 2006/1

Y1 - 2006/1

N2 - Objective: To assess the interobserver reliability of the main periarticular and intra-articular ultrasonographic pathologies and to establish the principal disagreements on scanning technique and diagnostic criteria between a group of experts in musculoskeletal ultrasonography. Methods: The shoulder, wrist/hand, ankle/foot, or knee of 24 patients with rheumatic diseases were evaluated by 23 musculoskeletal ultrasound experts from different European countries randomly assigned to six groups. The participants did not reach consensus on scanning method or diagnostic criteria before the investigation. They were unaware of the patients' clinical and imaging data. The experts from each group undertook a blinded ultrasound examination of the four anatomical regions. The ultrasound investigation included the presence/absence of joint effusion/synovitis, bony cortex abnormalities, tenosynovitis, tendon lesions, bursitis, and power Doppler signal. Afterwards they compared the ultrasound findings and re-examined the patients together while discussing their results. Results: Overall agreements were 91% for joint effusion/synovitis and tendon lesions, 87% for cortical abnormalities, 84% for tenosynovitis, 83.5% for bursitis, and 83% for power Doppler signal; κ values were good for the wrist/hand and knee (0.61 and 0.60) and fair for the shoulder and ankle/foot (0.50 and 0.54). The principal differences in scanning method and diagnostic criteria between experts were related to dynamic examination, definition of tendon lesions, and pathological v physiological fluid within joints, tendon sheaths, and bursae. Conclusions: Musculoskeletal ultrasound has a moderate to good interobserver reliability. Further consensus on standardisation of scanning technique and diagnostic criteria is necessary to improve musculoskeletal ultrasonography reproducibility.

AB - Objective: To assess the interobserver reliability of the main periarticular and intra-articular ultrasonographic pathologies and to establish the principal disagreements on scanning technique and diagnostic criteria between a group of experts in musculoskeletal ultrasonography. Methods: The shoulder, wrist/hand, ankle/foot, or knee of 24 patients with rheumatic diseases were evaluated by 23 musculoskeletal ultrasound experts from different European countries randomly assigned to six groups. The participants did not reach consensus on scanning method or diagnostic criteria before the investigation. They were unaware of the patients' clinical and imaging data. The experts from each group undertook a blinded ultrasound examination of the four anatomical regions. The ultrasound investigation included the presence/absence of joint effusion/synovitis, bony cortex abnormalities, tenosynovitis, tendon lesions, bursitis, and power Doppler signal. Afterwards they compared the ultrasound findings and re-examined the patients together while discussing their results. Results: Overall agreements were 91% for joint effusion/synovitis and tendon lesions, 87% for cortical abnormalities, 84% for tenosynovitis, 83.5% for bursitis, and 83% for power Doppler signal; κ values were good for the wrist/hand and knee (0.61 and 0.60) and fair for the shoulder and ankle/foot (0.50 and 0.54). The principal differences in scanning method and diagnostic criteria between experts were related to dynamic examination, definition of tendon lesions, and pathological v physiological fluid within joints, tendon sheaths, and bursae. Conclusions: Musculoskeletal ultrasound has a moderate to good interobserver reliability. Further consensus on standardisation of scanning technique and diagnostic criteria is necessary to improve musculoskeletal ultrasonography reproducibility.

UR - http://www.scopus.com/inward/record.url?scp=29144485638&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=29144485638&partnerID=8YFLogxK

U2 - 10.1136/ard.2005.037382

DO - 10.1136/ard.2005.037382

M3 - Article

VL - 65

SP - 14

EP - 19

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 1

ER -