Reproducibility of musculoskeletal ultrasound for determining monosodium urate deposition: concordance between readers.
Reproducibility of musculoskeletal ultrasound for determining monosodium urate deposition: concordance between readers.
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DOI：
10.1002/acr.20527
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发表时间：
2011-10
影响因子：
4.7
通讯作者：
Samuels, Jonathan
中科院分区：
文献类型：
--
作者：
Howard, Rennie G.;Pillinger, Michael H.;Gyftopoulos, Soterios;Thiele, Ralf G.;Swearingen, Christopher J.;Samuels, Jonathan
已制定了超声诊断尿酸盐（MSU）晶体沉积的标准，但该模式的阅片者间重现性尚未得到很好的建立。因此，我们使用系统方法评估了一致性。在城市VA医院的初级保健就诊期间招募了50名年龄为55-85岁的男性受试者，并通过膝关节和第一跖趾（MTP）关节的肌肉骨骼超声（MSK-US）进行评估，以评价“双轮廓”征和痛风石作为MSU晶体沉积的证据。由两名接受过MSK-US培训的双盲风湿病学家读取图像，并确定个体患者、全关节、股骨关节软骨（FAC）和第一MTP关节的一致性程度。将患者进一步分为三个诊断组：痛风、无症状高尿酸血症（AH）（无痛风，血清尿酸（UA）≥ 6.9 mg/dL）和对照组（无痛风，UA ≤ 6.8 mg/dL），并评估这三个组内的阅片者一致性。我们观察到阅片者之间几乎完全一致：1）个体患者（是/否）（n=50，100%一致性，kappa=1.000）; 2）总关节（n=200，99%一致性，kappa=0.942）; 3）FAC（n=100，99%一致性，kappa=0.942）;和4）第1个MTP（n=100，99%一致性，kappa=0.942）。此外，侧（右/左）和诊断组（痛风，AH，对照组）的结果显示所有测量结果基本一致至几乎完美一致。MSU沉积在痛风患者中最常见，在一些无症状高尿酸血症患者中也可见沉积，但仅在一个对照组中可见。MSK-US对FAC中MSU沉积和痛风及AH中第一MTP的检测是可靠的。
Criteria for sonographic diagnosis of monosodium urate (MSU) crystal deposition have been developed, but the inter-reader reproducibility of this modality is not well-established. We therefore assessed agreement using a systematic approach. 50 male subjects ages 55-85 were recruited during primary care visits to an urban VA hospital, and were assessed by musculoskeletal ultrasound (MSK-US) of the knees and 1st metatarsophalangeal (MTP) joints to evaluate for the “double contour” sign and tophi as evidence of MSU crystal deposition. Images were read by two blinded rheumatologists trained in MSK-US, and degree of concordance was determined for individual patients, total joints, femoral articular cartilage (FAC) and 1st MTP joints. Patients were further categorized into three diagnostic groups: gout, asymptomatic hyperuricemia (AH) (no gout, serum uric acid (UA) ≥ 6.9 mg/dL) and controls (no gout, UA ≤ 6.8 mg/dL), and reader concordance within these three groups was assessed. We observed almost perfect agreement between readers for: 1) individual patients (yes/no) (n=50, 100% agreement, kappa=1.000); 2) total joints (n=200, 99% agreement, kappa=0.942); 3) FAC (n=100, 99% agreement, kappa=0.942); and 4) 1st MTPs (n=100, 99% agreement, kappa=0.942). Furthermore, findings by side (right/left) and diagnostic group (gout, AH, control) showed substantial to almost perfect concordance for all measures. MSU deposition was seen most commonly in gout patients, and deposition was also seen in some patients with asymptomatic hyperuricemia, but in only one control. MSK-US is reliable for detecting MSU deposition in FAC and 1st MTPs in gout and AH.
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影响因子：
4.9
作者：
Pineda C;Amezcua-Guerra LM;Solano C;Rodriguez-Henríquez P;Hernández-Díaz C;Vargas A;Hofmann F;Gutiérrez M
通讯作者：
Gutiérrez M
影响因子：
27.4
作者：
Zhang, W.;Doherty, M.;Zimmermann-Gorska, I.
通讯作者：
Zimmermann-Gorska, I.
影响因子：
5.5
作者：
Thiele, R. G.;Schlesinger, N.
通讯作者：
Schlesinger, N.
影响因子：
2.3
作者：
Choi, Hyon
通讯作者：
Choi, Hyon
影响因子：
1.9
作者：
LANDIS, JR;KOCH, GG
通讯作者：
KOCH, GG