PT  - JOURNAL ARTICLE
AU  - Lene Terslev
AU  - Marwin Gutierrez
AU  - Robin Christensen
AU  - Peter V.  Balint
AU  - George A.  Bruyn
AU  - Andrea  Delle Sedie
AU  - Emilio Filippucci
AU  - Jesus Garrido
AU  - Hilde B.  Hammer
AU  - Annamaria Iagnocco
AU  - David Kane
AU  - Gurjit S.  Kaeley
AU  - Helen Keen
AU  - Peter Mandl
AU  - Esperanza Naredo
AU  - Carlos Pineda
AU  - Bernd Schicke
AU  - Ralf Thiele
AU  - Maria Antonietta  D’Agostino
AU  - Wolfgang A.  Schmidt
TI  - Assessing Elementary Lesions in Gout by Ultrasound: Results of an OMERACT Patient-based Agreement and Reliability Exercise
AID  - 10.3899/jrheum.150366
DP  - 2015 Oct 15
TA  - The Journal of Rheumatology
PG  - jrheum.150366
4099  - http://www.jrheum.org/content/early/2015/10/07/jrheum.150366.short
4100  - http://www.jrheum.org/content/early/2015/10/07/jrheum.150366.full
AB  - Objective To test the reliability of the consensus-based ultrasound (US) definitions of elementary gout lesions in patients. Methods Eight patients with microscopically proven gout were evaluated by 16 sonographers for signs of double contour (DC), aggregates, erosions, and tophi in the first metatarsophalangeal joint and the knee bilaterally. The patients were examined twice using B-mode US to test agreement and inter- and intraobserver reliability of the elementary components. Results The prevalence of the lesions were DC 52.8%, tophus 61.1%, aggregates 29.8%, and erosions 32.4%. The intraobserver reliability was good for all lesions except DC, where it was moderate. The best reliability per lesion was seen for tophus (κ 0.73, 95% CI 0.61–0.85) and lowest for DC (κ 0.53, 95% CI 0.38–0.67). The interobserver reliability was good for tophus and erosions, but fair to moderate for aggregates and DC, respectively. The best reliability was seen for erosions (κ 0.74, 95% CI 0.65–0.81) and lowest for aggregates (κ 0.21, 95% CI 0.04–0.37). Conclusion This is the first step to test consensus-based US definitions on elementary lesions in patients with gout. High intraobserver reliability was found when applying the definition in patients on all elementary lesions while interobserver reliability was moderate to low. Further studies are needed to improve the interobserver reliability, particularly for DC and aggregates.