Diagnostic value of ultrasound in calcium pyrophosphate deposition disease of the knee joint
Diagnostic value of ultrasound in calcium pyrophosphate deposition disease of the knee joint
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DOI：
10.1016/j.joca.2018.11.013
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发表时间：
2019-05-01
影响因子：
7
通讯作者：
Kim, H. -R.
中科院分区：
文献类型：
--
作者：
Lee, K. -A.;Lee, S. -H.;Kim, H. -R.
目的：为了评估超声（US）焦磷酸钙沉积（CPPD）的诊断性能，在水平上的tumerci，透明软骨（HC），肌腱，和滑液（SF）的膝盖，并检查inter-and intr-observer reliability.Design：我们连续纳入患者膝关节积液超过2年的时间（43例CPPD和131对照）。所有患者均接受SF分析、常规X线摄影（CR）和超声检查，使用流变学结局测量（OMERACT）定义CPPD的超声特征。两名独立的操作员进行了美国，并计算了观察员间的一致性。观察者内的协议进行了检查，获得了所有入组patients.Results静态图像：US显示焦磷酸钙（CPP）存款在aprici，HC，肌腱更频繁地与CPPD患者比对照组患者。两组之间SF中US CPP沉积物的存在无显著差异。三种成分（髂动脉、HC和肌腱）的联合超声评价显示出最佳诊断性能。超声评价三个组分的敏感性和特异性分别为74.4%和77.1%，而CR评价的敏感性和特异性分别为44.2%和96.9%。内侧（kappa = 0.930，0.972）和外侧（kappa = 0.905，0.942）、HC（kappa = 0.844，0.957）和SF（kappa = 0.817，0.925）的观察者间和观察者内一致性极佳。结论：根据OMERACT定义，超声对CPPD的诊断能力优于CR，具有良好的可靠性。联合评价股骨头、HC和肌腱的诊断准确性最高。(C)2019国际骨关节炎研究学会。由爱思唯尔有限公司出版。保留所有权利。
Objective: To assess the diagnostic performance of ultrasound (US) for calcium pyrophosphate deposition (CPPD) at the level of menisci, hyaline cartilage (HC), tendons, and synovial fluid (SF) of the knee, and to examine inter-and intra-observer reliability.Design: We consecutively included patients with knee effusion over a 2-year period (43 patients with CPPD and 131 controls). All patients underwent SF analysis, conventional radiography (CR), and US examination using the Outcome Measures in Rheumatology (OMERACT) definition of the US characteristics of CPPD. Two independent operators performed the US, and inter-observer agreement was calculated. Intra-observer agreement was examined with static images obtained for all enrolled patients.Results: US revealed calcium pyrophosphate (CPP) deposits in menisci, HC, and tendon more frequently in patients with CPPD than in control patients. The presence of US CPP deposits in SF was not significantly different between the two groups. Combined US evaluation of the three components (menisci, HC, and tendon) showed the best diagnostic performance. The sensitivity and specificity for US evaluation of the three components were 74.4% and 77.1%, respectively, while for CR evaluation, the sensitivity and specificity were 44.2% and 96.9%, respectively. Inter-and intra-observer agreement were excellent for medial (kappa = 0.930, 0.972) and lateral menisci (kappa = 0.905, 0.942), HC (kappa = 0.844, 0.957), and SF (kappa = 0.817, 0.925). Tendon showed fair inter-observer (kappa = 0.532) and good intra-observer reliability (kappa = 0.788).Conclusions: Based on the OMERACT definition, US demonstrated better diagnostic capacity than CR to diagnose CPPD, with excellent reliability. Combined evaluation of menisci, HC, and tendon showed the best diagnostic accuracy. (C) 2019 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.