TY - JOUR T1 - Ultrasound of Subtalar Joint Synovitis in Patients with Rheumatoid Arthritis: Results of an OMERACT Reliability Exercise Using Consensual Definitions JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.171490 SP - jrheum.171490 AU - George A.W. Bruyn AU - Heidi J. Siddle AU - Petra Hanova AU - Félicie Costantino AU - Annamaria Iagnocco AU - Andrea Delle Sedie AU - Marwin Gutierrez AU - Hilde B. Hammer AU - Elizabeth Jernberg AU - Damien Loeille AU - Mihaela C. Micu AU - Ingrid Moller AU - Carlos Pineda AU - Bethan Richards AU - Maria S. Stoenoiu AU - Takeshi Suzuki AU - Lene Terslev AU - Violeta Vlad AU - Robert Wonink AU - Maria-Antonietta d’Agostino AU - Richard J. Wakefield Y1 - 2018/11/01 UR - http://www.jrheum.org/content/early/2018/10/25/jrheum.171490.abstract N2 - Objective To evaluate the intraobserver and interobserver reliability of the ultrasonographic (US) assessment of subtalar joint (STJ) synovitis in patients with rheumatoid arthritis (RA). Methods Following a Delphi process, 12 sonographers conducted an US reliability exercise on 10 RA patients with hindfoot pain. The anteromedial, posteromedial, and posterolateral STJ was assessed using B-mode and power Doppler (PD) techniques according to an agreed US protocol and using a 4-grade semiquantitative grading score for synovitis [synovial hypertrophy (SH) and signal] and a dichotomous score for the presence of joint effusion (JE). Intraobserver and interobserver reliability were computed by Cohen’s and Light’s κ. Weighted κ coefficients with absolute weighting were computed for B-mode and PD signal. Results Mean weighted Cohen’s κ for SH, PD, and JE were 0.80 (95% CI 0.62–0.98), 0.61 (95% CI 0.48–0.73), and 0.52 (95% CI 0.36–0.67), respectively. Weighted Cohen’s κ for SH, PD, and JE in the anteromedial, posteromedial, and posterolateral STJ were –0.04 to 0.79, 0.42–0.95, and 0.28–0.77; 0.31–1, –0.05 to 0.65, and –0.2 to 0.69; 0.66–1, 0.52–1, and 0.42–0.88, respectively. Weighted Light’s κ for SH was 0.67 (95% CI 0.58–0.74), 0.46 (95% CI 0.35–0.59) for PD, and 0.16 (95% CI 0.08–0.27) for JE. Weighted Light’s κ for SH, PD, and JE were 0.63 (95% CI 0.45–0.82), 0.33 (95% CI 0.19–0.42), and 0.09 (95% CI –0.01 to 0.19), for the anteromedial; 0.49 (95% CI 0.27–0.64), 0.35 (95% CI 0.27–0.4), and 0.04 (95% CI –0.06 to 0.1) for posteromedial; and 0.82 (95% CI 0.75–0.89), 0.66 (95% CI 0.56–0.8), and 0.18 (95% CI 0.04–0.34) for posterolateral STJ, respectively. Conclusion Using a multisite assessment, US appears to be a reliable tool for assessing synovitis of STJ in RA. ER -