title: Global ultrasound assessment of structural lesions in osteoarthritis: a reliability study by the OMERACT ultrasonography group on scoring cartilage and osteophytes in finger joints.
abstract: OBJECTIVE
  Ultrasonography is sensitive for the evaluation of cartilage pathology and degree of osteophytes in patients with hand osteoarthritis (OA). High consistency of assessments is essential, and the OMERACT (Outcome Measures in Rheumatology) ultrasonography group took the initiative to explore the reliability of a global ultrasonography score in patients with hand OA using semiquantitative ultrasonography score of cartilage and osteophytes in finger joints.
  
  
  METHODS
  Ten patients with hand OA were examined by 10 experienced sonographers over the course of two days. Semiquantitative scoring (0-3) was performed on osteophytes (carpo-metacarpal 1, metacarpo-phalangeal (MCP) 1-5, proximal interphalangeal 1-5 and distal interphalangeal 2-5 joints bilaterally with an ultrasonography atlas as reference) and cartilage pathology (MCP 2-5 bilaterally). A web-based exercise on static cartilage images was performed a month later. Reliability was assessed by use of weighted κ analyses.
  
  
  RESULTS
  Osteophyte scores were evenly distributed, and the intraobserver and interobserver reliabilities were substantial to excellent (κ range 0.68-0.89 and mean κ 0.65 (day 1) and 0.67 (day 2), respectively). Cartilage scores were unevenly distributed, and the intraobserver and interobserver reliability was fair to moderate (κ range 0.46-0.66 and mean κ 0.39 (day 1) and 0.33 (day 2), respectively). The web-based exercise showed acceptable agreement for cartilage being normal (κ 0.47) or with complete loss (κ 0.68), but poor for the intermediate scores (κ 0.22-0.30).
  
  
  CONCLUSIONS
  Use of the present semiquantitative ultrasonography scoring system for cartilage pathology in hand OA is not recommended (while normal or total loss of cartilage may be assessed). However, the OMERACT ultrasonography group will endorse the use of semiquantitative scoring of osteophytes with the ultrasonography atlas as reference.
authors.affiliation: Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: H B
authors.initials: HB
authors.lastname: Hammer
authors.affiliation: Rheumatology Unit, Sapienza Università di Roma, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Iagnocco
authors.affiliation: Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: A
authors.initials: A
authors.lastname: Mathiessen
authors.affiliation: Clinica Reumatologica, Università Politecnica delle Marche, Jesi (Ancona), Italy.
authors.forename: E
authors.initials: E
authors.lastname: Filippucci
authors.affiliation: Department of Rheumatology, AP-HP, Pitie-Salpetriere Hospital, Paris, France UPMC Université Paris 06, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Gandjbakhch
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands Department of Rheumatology, Flevoziekenhuis, The Netherlands.
authors.forename: M C
authors.identifier: http://orcid.org/0000-0003-4334-552X
authors.initials: MC
authors.lastname: Kortekaas
authors.affiliation: Instituto Poal de Reumatologia, Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Möller
authors.affiliation: Department of Rheumatology, Hospital GU Gregorio Marañón, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Naredo
authors.affiliation: Leeds Institute of Rheumatic and Rehabilitation Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: Wakefield
authors.affiliation: Université Versailles-Saint Quentin En Yvelines, Paris, France Department of Public Health, AP-HP, Ambroise Paré Hospital, Boulogne-Billancourt, France.
authors.forename: P
authors.initials: P
authors.lastname: Aegerter
authors.affiliation: Université Versailles-Saint Quentin En Yvelines, Inserm U987, Boulogne-Billancourt, France Department of Rheumatology, AP-HP, Ambroise Paré Hospital, Boulogne-Billancourt, France.
authors.forename: M-A
authors.initials: MA
authors.lastname: D'Agostino
mesh_terms: D000368:Aged; D002356:Cartilage / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging* / Q000473:pathology; D006225:Hand / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D010003:Osteoarthritis / Q000000981:diagnostic imaging* / Q000473:pathology; D054850:Osteophyte / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014463:Ultrasonography
keywords: Hand Osteoarthritis; Osteoarthritis; Ultrasonography