title: Reliability testing of tendon disease using two different scanning methods in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To assess the intra- and interobserver reliability of musculoskeletal ultrasonography (US) in detecting inflammatory and destructive tendon abnormalities in patients with RA using two different scanning methods.
  
  
  METHODS
  Thirteen observers examined nine patients with RA and one healthy individual in two rounds independently and blindly of each other. Each round consisted of two consecutive examinations, an anatomy-based examination and a free examination according to personal preferences. The following tendons were evaluated: wrist extensor compartments 2, 4 and 6, finger flexor tendons 3 and 4 at MCP level, tibialis posterior tendon and both peronei tendons. Overall, positive and negative agreements and κ-values for greyscale (GS) tenosynovitis, peritendinous power Doppler (PPD) signal, intratendinous power Doppler (IPD) signal and GS tendon damage were calculated.
  
  
  RESULTS
  Intraobserver κ-value ranges were 0.53-0.55 (P < 0.0005) for GS tenosynovitis, 0.61-0.64 (P < 0.0005) for PPD signal, 0.65-0.66 (P < 0.0005) for IPD signal and 0.44-0.53 (P < 0.0005) for GS tendon damage. For interobserver reliability, substantial overall agreement ranged from 80 to 89% for GS tenosynovitis, 97 to 100% for PPD signal, 97 to 100% for IPD signal and 97 to 100% for GS tendon damage. Results were independent of scanning technique.
  
  
  CONCLUSIONS
  Intraobserver reliability for tenosynovitis and tendon damage varied from moderate for GS to good for PD. Overall interobserver reliability for tenosynovitis and tendon damage was excellent both for GS and PD. This qualitative scoring system may serve as the first step to a semi-quantitative score for tendon pathology.
authors.affiliation: Department of Rheumatology, MC Groep, Lelystad, The Netherlands. gawbruyn@wxs.nl
authors.forename: George A W
authors.initials: GA
authors.lastname: Bruyn
authors.forename: Ingrid
authors.initials: I
authors.lastname: Möller
authors.forename: Jesus
authors.initials: J
authors.lastname: Garrido
authors.forename: David
authors.initials: D
authors.lastname: Bong
authors.forename: Maria-Antonietta
authors.initials: MA
authors.lastname: d'Agostino
authors.forename: Annamaria
authors.initials: A
authors.lastname: Iagnocco
authors.forename: Zunaid
authors.initials: Z
authors.lastname: Karim
authors.forename: Lene
authors.initials: L
authors.lastname: Terslev
authors.forename: Nanno
authors.initials: N
authors.lastname: Swen
authors.forename: Peter
authors.initials: P
authors.lastname: Balint
authors.forename: Paul
authors.initials: P
authors.lastname: Baudoin
authors.forename: Dick Siewertsz
authors.initials: DS
authors.lastname: van Reesema
authors.forename: Carlos
authors.initials: C
authors.lastname: Pineda
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wakefield
authors.forename: Esperanza
authors.initials: E
authors.lastname: Naredo
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D018579:Patient Selection; D015203:Reproducibility of Results; D012421:Rupture; D013708:Tendon Injuries / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D013710:Tendons / Q000000981:diagnostic imaging / Q000473:pathology*; D013717:Tenosynovitis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D014463:Ultrasonography / Q000379:methods*
chemical_list: D018501:Antirheumatic Agents