Ultrasound definition of tendon damage in patients with rheumatoid arthritis. Results of a OMERACT consensus-based ultrasound score focussing on the diagnostic reliability

作者：Bruyn George A W^*; Hanova Petra; Iagnocco Annamaria; d' Agostino Maria Antonietta; Moeller Ingrid; Terslev Lene; Backhaus Marina; Balint Peter V; Filippucci Emilio; Baudoin Paul; van Vugt Richard; Pineda Carlos; Wakefield Richard; Garrido Jesus; Pecha Ondrej; Naredo Esperanza

来源：Annals of the Rheumatic Diseases, 2014, 73(11): 1929-1934.

DOI：10.1136/annrheumdis-2013-203596

Objective To develop the first ultrasound scoring system of tendon damage in rheumatoid arthritis (RA) and assess its intraobserver and interobserver reliability. %26lt;br%26gt;Methods We conducted a Delphi study on ultrasound-defined tendon damage and ultrasound scoring system of tendon damage in RA among 35 international rheumatologists with experience in musculoskeletal ultrasound. Twelve patients with RA were included and assessed twice by 12 rheumatologists-sonographers. Ultrasound examination for tendon damage in B mode of five wrist extensor compartments (extensor carpi radialis brevis and longus; extensor pollicis longus; extensor digitorum communis; extensor digiti minimi; extensor carpi ulnaris) and one ankle tendon (tibialis posterior) was performed blindly, independently and bilaterally in each patient. Intraobserver and interobserver reliability were calculated by. coefficients. %26lt;br%26gt;Results A three-grade semiquantitative scoring system was agreed for scoring tendon damage in B mode. The mean intraobserver reliability for tendon damage scoring was excellent (kappa value 0.91). The mean interobserver reliability assessment showed good. values (kappa value 0.75). The most reliable were the extensor digiti minimi, the extensor carpi ulnaris, and the tibialis posterior tendons. An ultrasound reference image atlas of tenosynovitis and tendon damage was also developed. %26lt;br%26gt;Conclusions Ultrasound is a reproducible tool for evaluating tendon damage in RA. This study strongly supports a new reliable ultrasound scoring system for tendon damage.

• 出版日期2014-11