The OMERACT Ultrasound Working Group 10 Years On: Update at OMERACT 12

Bruyn, G. A. W.; Naredo, Esperanza; Iagnocco, Annamaria; Bálint, Péter; Backhaus, Marina; Gandjbakhch, Frédérique; Gutiérrez, Marwin; Filer, Andrew; Finzel, Stephanie; Ikeda, Kei; Kaeley, Gurjit S.; Magni‐Manzoni, Silvia; Ohrndorf, Sarah; Pineda, Carlos; Richards, Bethan; Roth, Johannes; Schmidt, Wolfgang A.; Terslev, Lene; D’Agostino, Maria

doi:10.3899/jrheum.141462

Cited by 25 publications

(20 citation statements)

References 20 publications

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“…Over the last decade, the OMERACT MSUS group has assessed the metric properties of US in detecting and scoring potential endpoint in rheumatic diseases for clinical trials and practice [24][25][26][27][28]. The group has worked on validation of US-detected and graded tendon damage in RA [19,20], which is an essential component of the structural damage in this disease [19,20].…”

Section: Discussionmentioning

confidence: 99%

How does a cadaver model work for testing ultrasound diagnostic capability for rheumatic-like tendon damage?

et al. 2016

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(1); or complete tear (2). All 20 tendons were blindly and independently evaluated twice, over two rounds, by each of the three observers. Overall, technical performance was satisfactory for all items in the two rounds (all values over 2.9 in a Likert scale 1-5). Intraobserver and interobserver agreement for US grading of tendon damage was good (mean κ values 0.62 and 0.71, respectively), with greater reliability found in the TAT than the TPT. Concordance between US findings and experimental tendon lesions was acceptable (70-100 %), again greater for the TAT than for the TPT. A cadaver model with surgically created tendon damage can be useful in evaluating US metric properties of RA tendon lesions Keywords Tendon tear · Tendon damage · Ultrasound · Cadaver · Specimen Abstract To establish whether a cadaver model can serve as an effective surrogate for the detection of tendon damage characteristic of rheumatoid arthritis (RA). In addition, we evaluated intraobserver and interobserver agreement in the grading of RA-like tendon tears shown by US, as well as the concordance between the US findings and the surgically induced lesions in the cadaver model. RA-like tendon damage was surgically induced in the tibialis anterior tendon (TAT) and tibialis posterior tendon (TPT) of ten ankle/ foot fresh-frozen cadaveric specimens. Of the 20 tendons examined, six were randomly assigned a surgically induced partial tear; six a complete tear; and eight left undamaged. Three rheumatologists, experts in musculoskeletal US, assessed from 1 to 5 the quality of US imaging of the cadaveric models on a Likert scale. Tendons were then categorized as having either no damage, (0); partial tear, Electronic supplementary material The online version of this article

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Section: Discussionmentioning

confidence: 99%

How does a cadaver model work for testing ultrasound diagnostic capability for rheumatic-like tendon damage?

et al. 2016

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“…There are limited data in children, although work on B mode and Doppler ultrasound is currently under way. 33 Ultrasound definitions of common lesions found in adult inflammatory arthritis (Table 4) were agreed upon in 2005 by the OMERACT group 34 and are broadly adopted for use in children.…”

Section: Ultrasound Findings In Juvenile Idiopathic Arthritismentioning

confidence: 99%

Juvenile idiopathic arthritis: what is the utility of ultrasound?

Basra

Humphries

2017

BJR

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Juvenile idiopathic arthritis (JIA) is a heterogeneous condition and an important cause of acquired disability in children. Evidence supports early treatment to prevent future complications. This relies on prompt diagnosis, achieved by a high index of clinical suspicion and supportive evidence, including the detection of joint and or tendon inflammation. Ultrasound is a readily accessible, well-tolerated, safe and accurate modality for assessing joints and the surrounding soft tissues. It can also be used to guide therapy into those joints and tendon sheaths resistant to systemic treatments. Ultrasound imaging is highly operator dependent, and the developing skeleton poses unique challenges in interpretation with sonographic findings that can mimic pathology and vice versa. Ultrasound technology has been rapidly improving and is more accessible than ever before. In this article, we review the normal appearances, highlight potential pitfalls and present the key pathological findings commonly seen in JIA.

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“…Toward that end, several semiquantitative musculoskeletal US scoring algorithms have been proposed, especially for the detection of early changes . However, these scoring algorithms lack iterative validation processes (“truth, discrimination, and feasibility”), as proposed by Outcome Measures in Rheumatology (OMERACT) . Additionally, scoring algorithms are relatively subjective, may have ceiling effects in advanced hemophilic arthropathy, and do not permit the following of individual findings in hemophilic joints, which may be central to patients’ specific presentations but outside the scoring algorithms.…”

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“…The protocol was designed to capture fluctuating soft tissue changes, precisely measure osteochondral surface and cartilage alterations, and enable dynamic follow‐up of individual, patient‐specific intra‐articular findings. Here we describe the development of JADE with the objective of reporting intra‐ and inter‐rater as well as inter‐operator reliability among a group of hemophilia providers trained and experienced in musculoskeletal US assessments of hemophilic joints, aligning our efforts with OMERACT for the validation of US imaging techniques …”

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confidence: 99%

“…The OMERACT guidelines are considered the “reference standard” for validating imaging protocols for the assessment of arthritic changes, and following those guidelines appeared essential to provide confidence that the JADE parameters would bear relevance as outcome tools. OMERACT is a widely accepted international initiative, whereby the cornerstones of validation are composed of correct tissue annotation, the establishment of intra‐rater, inter‐rater, and inter‐operator reliability, and clinical applicability for specific disease states and patient cohorts, emulating the OMERACT filter components truth, discrimination, and feasibility . Along OMERACT recommendations, we recently established the extent of pathologic tissue discrimination with musculoskeletal US specific to hemophilic joints by comparison with conventional and ultrashort time‐to‐echo magnetic resonance imaging …”

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Development and Reliability of the Joint Tissue Activity and Damage Examination for Quantitation of Structural Abnormalities by Musculoskeletal Ultrasound in Hemophilic Joints

Volland

Zhou

Barnes

et al. 2018

J of Ultrasound Medicine

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Objectives Musculoskeletal ultrasound (US) is used increasingly to examine hemophilic arthropathy. However, quantitative algorithms to document findings are lacking. We developed and sought to validate a protocol quantifying hemophilic joint abnormalities. Methods Thirty‐one patients with hemophilia were examined serially for 2 years with musculoskeletal US (≈600 joint examinations and ≈6000 images). Based on the spectrum of pathologies, a quantitative algorithm, named Joint Tissue Activity and Damage Examination (JADE), was developed for soft tissue and osteochondral measurements, including power Doppler, using nominal group techniques. To study intra‐ and inter‐rater reliability, 8 musculoskeletal US–experienced hemophilia providers performed anatomic landmark recognition and tissue measurements on 86 images with arthropathic changes, with repetition 1 month later. Twenty‐three musculoskeletal US–inexperienced providers performed similar assessments. Inter‐operator reliability was established by 6 musculoskeletal US–experienced hemophilia providers, each acquiring images and JADE assessments of 3 hemophilic arthropathic joints. A radiologist and musculoskeletal sonographer functioned as adjudicators. The statistical analysis was performed with the intraclass correlation coefficient (ICC), Fleiss κ, and Cohen κ where appropriate. Results The musculoskeletal US–experienced providers showed excellent intra‐and inter‐rater reliability for tissue measurements (ICCs, 0.94–0.96). Agreement was good to excellent for landmark recognition (Fleiss κ, 0.87‐0.94). Inter‐operator reliability was excellent for measurements and landmark recognition (ICC, 0.90; Fleiss κ, 1.0). Agreement with adjudicators was mostly good to excellent. Musculoskeletal US–inexperienced providers showed excellent inter‐rater reliability for measurements (ICC, 0.96) and moderate agreement for landmark recognition (Fleiss κ, 0.58). Conclusions The JADE protocol appears feasible for quantifying hemophilic intra‐articular abnormalities. Musculoskeletal US–trained hemophilia providers showed high intra‐rater, inter‐rater, and inter‐operator reliability, supporting JADE as a protocol for clinical management and research.

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The OMERACT Ultrasound Working Group 10 Years On: Update at OMERACT 12

Cited by 25 publications

References 20 publications

How does a cadaver model work for testing ultrasound diagnostic capability for rheumatic-like tendon damage?

How does a cadaver model work for testing ultrasound diagnostic capability for rheumatic-like tendon damage?

Juvenile idiopathic arthritis: what is the utility of ultrasound?

Development and Reliability of the Joint Tissue Activity and Damage Examination for Quantitation of Structural Abnormalities by Musculoskeletal Ultrasound in Hemophilic Joints

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