Diagnosis of synovitis by ultrasonography in RA: A one-year experience is enough for reliability on static images - 21/01/09
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Abstract |
Objective |
To evaluate the inter- and intra-observer agreement of ultrasonographic metacarpophalangeal joint static images in patients with rheumatoid arthritis by two investigators with different ultrasonographic experience.
Methods |
Ultrasonography was performed by the senior on 386 metacarpophalangeal joints respectively in B-mode and 408 in power Doppler of 17 patients with active rheumatoid arthritis. A first interpretation was done and images were stored at examination time. Static images were then read twice by two independent investigators of different experiment (4-year and 1-year experience in musculoskeletal ultrasonography respectively for the senior and the junior).
Results |
For the intra-investigator reproducibility kappa or weighted kappa coefficient ranged from 0.74 to 0.99 for the junior and the senior for B and power Doppler mode. For inter-investigator reproducibility kappa or weighted kappa coefficient ranged from 0.61 and 0.98 for qualitative B and power Doppler modes and semi-quantitative power Doppler. The inter-investigator weighted kappa was 0.49 for semi-quantitative B-mode. The agreement between the dynamic exam and the static exam; results were very good for both readers in power Doppler Mode (0.89). In B-Mode, they didn't reach statistical significance. The reliability for measuring synovial thickness was excellent – rho=0.7609 (p=0.00001).
Conclusion |
An experienced rheumatologist and a junior achieved high inter- and intra-observer agreement rates for the identification of synovitis and power Doppler activity for static images of ultrasonography. Trainees could use that method as a first step in US learning.
Le texte complet de cet article est disponible en PDF.Keywords : Rheumatoid arthritis, Ultrasonography, Synovitis
Plan
Vol 76 - N° 1
P. 35-38 - janvier 2009 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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