Examination of intra and interrater reliability with a new ultrasonographic reference atlas for scoring of synovitis in patients with rheumatoid arthritis

Synovitis in patients with rheumatoid arthritis (RA) may be scored semiquantitatively (0-3) for B-mode (BM) and power Doppler (PD) ultrasonography. The objective was to assess the reliability of BM and PD examinations with a novel ultrasonographic atlas as reference. Representative ultrasound images...

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Bibliographic Details
Published in:	Annals of the rheumatic diseases Vol. 70; no. 11; p. 1995
Main Authors:	Hammer, Hilde Berner, Bolton-King, Pernille, Bakkeheim, Vivi, Berg, Torill Helene, Sundt, Elisabeth, Kongtorp, Anne Katrine, Haavardsholm, Espen A
Format:	Journal Article
Language:	English
Published:	England 01-11-2011
Subjects:	Adult Aged Arthritis, Rheumatoid - complications Arthritis, Rheumatoid - diagnostic imaging Atlases as Topic Female Humans Male Metacarpophalangeal Joint - diagnostic imaging Metatarsophalangeal Joint - diagnostic imaging Middle Aged Observer Variation Reproducibility of Results Synovitis - diagnostic imaging Synovitis - etiology Ultrasonography, Doppler - methods
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Summary:	Synovitis in patients with rheumatoid arthritis (RA) may be scored semiquantitatively (0-3) for B-mode (BM) and power Doppler (PD) ultrasonography. The objective was to assess the reliability of BM and PD examinations with a novel ultrasonographic atlas as reference. Representative ultrasound images (including scores 0-3) of BM and PD from 24 different joints were collected to develop an ultrasonographic atlas. Ten RA patients were assessed twice by five rheumatologists performing BM and PD scoring (0-3) of 16 joints bilaterally (metacarpophalangeal 1-5, wrist (radiocarpal, intercarpal, radioulnar), elbow, knee, talocrural and metatarsophalangeal 1-5), with the novel ultrasonographic atlas as a reference. The median (range) percentages of exact agreements for BM/PD assessments were 73.1 (70.3-80.6)/83.7 (76.7-87.6) and for close agreement 98.1 (96.2-99.7)/98.0 (96.8-98.4) with weighted κ values of median (range) 0.77 (0.70-0.83) for BM and 0.83 (0.73-0.86) for PD. The intrarater intraclass correlation coefficients (ICC) for BM/PD scores were 0.95 (0.93-0.99)/0.97 (0.95-0.99) and interrater ICC were 0.95 (0.86-0.99)/0.97 (0.94-1.00). Scoring of 32 joints was completed in median 15 min (range 12-20). With the use of an ultrasonographic atlas as reference high intra and interrater reliability was found for BM and PD scoring. This novel atlas may be a useful resource in clinical practice and research.
ISSN:	1468-2060
DOI:	10.1136/ard.2011.152926