Reliability of a consensus-based ultrasound score for tenosynovitis in rheumatoid arthritis

Esperanza Naredo, Maria Antonietta D'Agostino, Richard J. Wakefield, Ingrid Möller, P. Bálint, Emilio Filippucci, Annamaria Iagnocco, Zunaid Karim, Lene Terslev, David A. Bong, Jesús Garrido, David Martínez-Hernández, George A W Bruyn

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Abstract

Objective To produce consensus-based scoring systems for ultrasound (US) tenosynovitis and to assess the intraobserver and interobserver reliability of these scoring systems in rheumatoid arthritis (RA). Methods We undertook a Delphi process on US-defined tenosynovitis and US scoring system of tenosynovitis in RA among 35 rheumatologists, experts in musculoskeletal US (MSUS), from 16 countries. Then, we assessed the intraobserver and interobserver reliability of US in scoring tenosynovitis on B-mode and with a power Doppler (PD) technique. Ten patients with RA with symptoms in the hands or feet were recruited. Ten rheumatologists expert in MSUS blindly, independently and consecutively scored for tenosynovitis in B-mode and PD mode three wrist extensor compartments, two finger flexor tendons and two ankle tendons of each patient in two rounds in a blinded fashion. Intraobserver reliability was assessed by Cohen's ê. Interobserver reliability was assessed by Light's ê. Weighted ê coefficients with absolute weighting were computed for B-mode and PD signal. Results Four-grade semiquantitative scoring systems were agreed upon for scoring tenosynovitis in B-mode and for scoring pathological peritendinous Doppler signal within the synovial sheath. The intraobserver reliability for tenosynovitis scoring on B-mode and PD mode was good (ê value 0.72 for B-mode; ê value 0.78 for PD mode). Interobserver reliability assessment showed good ê values for PD tenosynovitis scoring (first round, 0.64; second round, 0.65) and moderate ê values for B-mode tenosynovitis scoring (first round, 0.47; second round, 0.45). Conclusions US appears to be a reproducible tool for evaluating and monitoring tenosynovitis in RA.

Original languageEnglish
Pages (from-to)1328-1334
Number of pages7
JournalAnnals of the Rheumatic Diseases
Volume72
Issue number8
DOIs
Publication statusPublished - Aug 2013

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Tenosynovitis
Rheumatoid Arthritis
Ultrasonics
Tendons
Wrist
Ankle
Monitoring
Fingers
Foot
Hand

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Allergy

Cite this

Naredo, E., D'Agostino, M. A., Wakefield, R. J., Möller, I., Bálint, P., Filippucci, E., ... Bruyn, G. A. W. (2013). Reliability of a consensus-based ultrasound score for tenosynovitis in rheumatoid arthritis. Annals of the Rheumatic Diseases, 72(8), 1328-1334. https://doi.org/10.1136/annrheumdis-2012-202092

Reliability of a consensus-based ultrasound score for tenosynovitis in rheumatoid arthritis. / Naredo, Esperanza; D'Agostino, Maria Antonietta; Wakefield, Richard J.; Möller, Ingrid; Bálint, P.; Filippucci, Emilio; Iagnocco, Annamaria; Karim, Zunaid; Terslev, Lene; Bong, David A.; Garrido, Jesús; Martínez-Hernández, David; Bruyn, George A W.

In: Annals of the Rheumatic Diseases, Vol. 72, No. 8, 08.2013, p. 1328-1334.

Research output: Contribution to journalArticle

Naredo, E, D'Agostino, MA, Wakefield, RJ, Möller, I, Bálint, P, Filippucci, E, Iagnocco, A, Karim, Z, Terslev, L, Bong, DA, Garrido, J, Martínez-Hernández, D & Bruyn, GAW 2013, 'Reliability of a consensus-based ultrasound score for tenosynovitis in rheumatoid arthritis', Annals of the Rheumatic Diseases, vol. 72, no. 8, pp. 1328-1334. https://doi.org/10.1136/annrheumdis-2012-202092
Naredo, Esperanza ; D'Agostino, Maria Antonietta ; Wakefield, Richard J. ; Möller, Ingrid ; Bálint, P. ; Filippucci, Emilio ; Iagnocco, Annamaria ; Karim, Zunaid ; Terslev, Lene ; Bong, David A. ; Garrido, Jesús ; Martínez-Hernández, David ; Bruyn, George A W. / Reliability of a consensus-based ultrasound score for tenosynovitis in rheumatoid arthritis. In: Annals of the Rheumatic Diseases. 2013 ; Vol. 72, No. 8. pp. 1328-1334.
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abstract = "Objective To produce consensus-based scoring systems for ultrasound (US) tenosynovitis and to assess the intraobserver and interobserver reliability of these scoring systems in rheumatoid arthritis (RA). Methods We undertook a Delphi process on US-defined tenosynovitis and US scoring system of tenosynovitis in RA among 35 rheumatologists, experts in musculoskeletal US (MSUS), from 16 countries. Then, we assessed the intraobserver and interobserver reliability of US in scoring tenosynovitis on B-mode and with a power Doppler (PD) technique. Ten patients with RA with symptoms in the hands or feet were recruited. Ten rheumatologists expert in MSUS blindly, independently and consecutively scored for tenosynovitis in B-mode and PD mode three wrist extensor compartments, two finger flexor tendons and two ankle tendons of each patient in two rounds in a blinded fashion. Intraobserver reliability was assessed by Cohen's {\^e}. Interobserver reliability was assessed by Light's {\^e}. Weighted {\^e} coefficients with absolute weighting were computed for B-mode and PD signal. Results Four-grade semiquantitative scoring systems were agreed upon for scoring tenosynovitis in B-mode and for scoring pathological peritendinous Doppler signal within the synovial sheath. The intraobserver reliability for tenosynovitis scoring on B-mode and PD mode was good ({\^e} value 0.72 for B-mode; {\^e} value 0.78 for PD mode). Interobserver reliability assessment showed good {\^e} values for PD tenosynovitis scoring (first round, 0.64; second round, 0.65) and moderate {\^e} values for B-mode tenosynovitis scoring (first round, 0.47; second round, 0.45). Conclusions US appears to be a reproducible tool for evaluating and monitoring tenosynovitis in RA.",
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T1 - Reliability of a consensus-based ultrasound score for tenosynovitis in rheumatoid arthritis

AU - Naredo, Esperanza

AU - D'Agostino, Maria Antonietta

AU - Wakefield, Richard J.

AU - Möller, Ingrid

AU - Bálint, P.

AU - Filippucci, Emilio

AU - Iagnocco, Annamaria

AU - Karim, Zunaid

AU - Terslev, Lene

AU - Bong, David A.

AU - Garrido, Jesús

AU - Martínez-Hernández, David

AU - Bruyn, George A W

PY - 2013/8

Y1 - 2013/8

N2 - Objective To produce consensus-based scoring systems for ultrasound (US) tenosynovitis and to assess the intraobserver and interobserver reliability of these scoring systems in rheumatoid arthritis (RA). Methods We undertook a Delphi process on US-defined tenosynovitis and US scoring system of tenosynovitis in RA among 35 rheumatologists, experts in musculoskeletal US (MSUS), from 16 countries. Then, we assessed the intraobserver and interobserver reliability of US in scoring tenosynovitis on B-mode and with a power Doppler (PD) technique. Ten patients with RA with symptoms in the hands or feet were recruited. Ten rheumatologists expert in MSUS blindly, independently and consecutively scored for tenosynovitis in B-mode and PD mode three wrist extensor compartments, two finger flexor tendons and two ankle tendons of each patient in two rounds in a blinded fashion. Intraobserver reliability was assessed by Cohen's ê. Interobserver reliability was assessed by Light's ê. Weighted ê coefficients with absolute weighting were computed for B-mode and PD signal. Results Four-grade semiquantitative scoring systems were agreed upon for scoring tenosynovitis in B-mode and for scoring pathological peritendinous Doppler signal within the synovial sheath. The intraobserver reliability for tenosynovitis scoring on B-mode and PD mode was good (ê value 0.72 for B-mode; ê value 0.78 for PD mode). Interobserver reliability assessment showed good ê values for PD tenosynovitis scoring (first round, 0.64; second round, 0.65) and moderate ê values for B-mode tenosynovitis scoring (first round, 0.47; second round, 0.45). Conclusions US appears to be a reproducible tool for evaluating and monitoring tenosynovitis in RA.

AB - Objective To produce consensus-based scoring systems for ultrasound (US) tenosynovitis and to assess the intraobserver and interobserver reliability of these scoring systems in rheumatoid arthritis (RA). Methods We undertook a Delphi process on US-defined tenosynovitis and US scoring system of tenosynovitis in RA among 35 rheumatologists, experts in musculoskeletal US (MSUS), from 16 countries. Then, we assessed the intraobserver and interobserver reliability of US in scoring tenosynovitis on B-mode and with a power Doppler (PD) technique. Ten patients with RA with symptoms in the hands or feet were recruited. Ten rheumatologists expert in MSUS blindly, independently and consecutively scored for tenosynovitis in B-mode and PD mode three wrist extensor compartments, two finger flexor tendons and two ankle tendons of each patient in two rounds in a blinded fashion. Intraobserver reliability was assessed by Cohen's ê. Interobserver reliability was assessed by Light's ê. Weighted ê coefficients with absolute weighting were computed for B-mode and PD signal. Results Four-grade semiquantitative scoring systems were agreed upon for scoring tenosynovitis in B-mode and for scoring pathological peritendinous Doppler signal within the synovial sheath. The intraobserver reliability for tenosynovitis scoring on B-mode and PD mode was good (ê value 0.72 for B-mode; ê value 0.78 for PD mode). Interobserver reliability assessment showed good ê values for PD tenosynovitis scoring (first round, 0.64; second round, 0.65) and moderate ê values for B-mode tenosynovitis scoring (first round, 0.47; second round, 0.45). Conclusions US appears to be a reproducible tool for evaluating and monitoring tenosynovitis in RA.

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