PT  - JOURNAL ARTICLE
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
TI  - Ultrasound of Subtalar Joint Synovitis in Patients with Rheumatoid Arthritis: Results of an OMERACT Reliability Exercise Using Consensual Definitions
AID  - 10.3899/jrheum.171490
DP  - 2019 Apr 01
TA  - The Journal of Rheumatology
PG  - 351--359
VI  - 46
IP  - 4
4099  - http://www.jrheum.org/content/46/4/351.short
4100  - http://www.jrheum.org/content/46/4/351.full
SO  - J Rheumatol2019 Apr 01; 46
AB  - 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.