Reliability of a consensus-based ultrasound score for tenosynovitis in rheumatoid arthritis
Reliability of a consensus-based ultrasound score for tenosynovitis in rheumatoid arthritis
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DOI：
10.1136/annrheumdis-2012-202092
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发表时间：
2013-08-01
影响因子：
27.4
通讯作者：
Bruyn, George A. W.
中科院分区：
文献类型：
--
作者：
Naredo, Esperanza;D'Agostino, Maria Antonietta;Bruyn, George A. W.
目的建立超声（US）诊断类风湿关节炎（RA）腱鞘炎的评分系统，并评价其观察者内和观察者间的可靠性。方法采用德尔菲法，对来自16个国家的35名风湿病学家、肌肉骨骼超声（MSUS）专家进行美国定义的RA腱鞘炎和US评分。然后，我们评估了观察者内和观察者间的可靠性，美国评分腱鞘炎的B型和能量多普勒（PD）技术。招募了10名手或脚有症状的RA患者。10名风湿病专家在MSUS中盲法、独立和连续地在B型和PD型中对每个患者的三个腕伸肌间室、两个手指屈肌腱和两个踝肌腱进行两轮盲法评分。观察者内可靠性由Cohen评估。观察者间的可靠性由Light’s评估。结果采用4级半定量评分系统对腱鞘炎进行B超评分，对滑膜鞘内病理性腱周多普勒信号进行评分。B模式和PD模式下腱鞘炎评分的观察者内可靠性良好（B模式值为0.72; PD模式值为0.78）。观察者间可靠性评估显示PD腱鞘炎评分值良好（第一轮，0.64;第二轮，0.65）和B型腱鞘炎评分值中等（第一轮，0.47;第二轮，0.45）。
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 . Interobserver reliability was assessed by Light's . Weighted 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 ( value 0.72 for B-mode; value 0.78 for PD mode). Interobserver reliability assessment showed good values for PD tenosynovitis scoring (first round, 0.64; second round, 0.65) and moderate 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.