RT Journal Article
SR Electronic
T1 Assessing Elementary Lesions in Gout by Ultrasound: Results of an OMERACT Patient-based Agreement and Reliability Exercise
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.150366
DO 10.3899/jrheum.150366
A1 Lene Terslev
A1 Marwin Gutierrez
A1 Robin Christensen
A1 Peter V.  Balint
A1 George A.  Bruyn
A1 Andrea  Delle Sedie
A1 Emilio Filippucci
A1 Jesus Garrido
A1 Hilde B.  Hammer
A1 Annamaria Iagnocco
A1 David Kane
A1 Gurjit S.  Kaeley
A1 Helen Keen
A1 Peter Mandl
A1 Esperanza Naredo
A1 Carlos Pineda
A1 Bernd Schicke
A1 Ralf Thiele
A1 Maria Antonietta  D’Agostino
A1 Wolfgang A.  Schmidt
YR 2015
UL http://www.jrheum.org/content/early/2015/10/07/jrheum.150366.abstract
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.