RESUMEN
The aim of this study was to evaluate the reliability of the outcome measures in rheumatology (OMERACT) definitions for ultrasound (US) elementary lesions in gout through an image reading exercise. Images from patients with gout (static images and videos) were collected. As an initial step, we carried out a image reading exercise within the experts of the Pan-American League of Associations for Rheumatology (PANLAR) US Study Group (n = 16). The following step consisted in a web-based exercise with the participation of larger number of sonographers (n = 63) from different centers. Images were rated evaluating the presence/absence of any US elementary lesion. Inter- and intra-reader reliabilities were analyzed using kappa coefficients. Participants were stratified according to their level of experience. In the first exercise, inter-reader kappa values were 0.45 for aggregates, 0.57 for tophus, 0.69 for erosions, and 0.90 for double contour (DC). Intra-reader kappa values were 0.86, 0.76, 0.80, and 0.90, respectively. The web-based exercise showed inter-reader kappa values for aggregates, tophus, erosions, and DC of 0.42, 0.49, 0.69, and 0.79, respectively. The intra-reader kappa values were 0.62, 0.69, 0.77, and 0.85, respectively. Reliability was not influenced by the sonographer's level of experience. The reliability of the new OMERACT US definitions for elementary lesions in gout ranged from moderate to excellent, depending on the type of lesion.
Asunto(s)
Gota/diagnóstico por imagen , Estudios Transversales , Humanos , Reproducibilidad de los Resultados , UltrasonografíaRESUMEN
El complejo de la articulación del codo está formado por tres articulaciones diferentes que permiten la conexión mecánica de la extremidad superior entre el brazo y el antebrazo. Sus propiedades biomecánicas únicas lo hacen susceptible de lesiones deportivas y por uso excesivo. Es también afectada en las enfermedades inflamatorias sistémicas con cierta frecuencia. La evaluación por radiología simple es muy limitada, razón por la cual el ultrasonido musculoesquelético podría ser de mayor utilidad en el estudio de esta articulación. Las ventajas del ultrasonido musculoesquelético son su bajo costo, su accesibilidad y la posibilidad de evaluar en tiempo real diversas estructuras anatómicas osteomusculares. En este artículo se detallará la exploración sistematizada del codo por ultrasonografía.
The complex of the elbow joint is composed of three joints that allow for a mechanical connection of the upper limb between the arm and forearm. Unique biomechanical properties make it susceptible to sports injuries and overuse. It is also affected in systemic inflammatory disease with some frequency. The evaluation by plain radiography is very limited, why musculoskeletal ultrasound might be more useful in the study of this joint. The advantages of musculoskeletal ultrasound are its low cost, accessibility and the ability to assess real-time musculoskeletal various anatomical structures. This article will detail the systematic exploration of the elbow by ultrasonography.