title: Assessing Elementary Lesions in Gout by Ultrasound: Results of an OMERACT Patient-based Agreement and Reliability Exercise.
abstract: OBJECTIVE
  To test the reliability of the consensus-based ultrasound (US) definitions of elementary gout lesions in patients.
  
  
  METHODS
  Eight patients with microscopically proven gout were evaluated by 16 sonographers for signs of double contour (DC), aggregates, erosions, and tophi in the first metatarsophalangeal joint and the knee bilaterally. The patients were examined twice using B-mode US to test agreement and inter- and intraobserver reliability of the elementary components.
  
  
  RESULTS
  The prevalence of the lesions were DC 52.8%, tophus 61.1%, aggregates 29.8%, and erosions 32.4%. The intraobserver reliability was good for all lesions except DC, where it was moderate. The best reliability per lesion was seen for tophus (κ 0.73, 95% CI 0.61-0.85) and lowest for DC (κ 0.53, 95% CI 0.38-0.67). The interobserver reliability was good for tophus and erosions, but fair to moderate for aggregates and DC, respectively. The best reliability was seen for erosions (κ 0.74, 95% CI 0.65-0.81) and lowest for aggregates (κ 0.21, 95% CI 0.04-0.37).
  
  
  CONCLUSIONS
  This is the first step to test consensus-based US definitions on elementary lesions in patients with gout. High intraobserver reliability was found when applying the definition in patients on all elementary lesions while interobserver reliability was moderate to low. Further studies are needed to improve the interobserver reliability, particularly for DC and aggregates.
authors.forename: Lene
authors.initials: L
authors.lastname: Terslev
authors.forename: Marwin
authors.initials: M
authors.lastname: Gutierrez
authors.forename: Robin
authors.initials: R
authors.lastname: Christensen
authors.forename: Peter V
authors.initials: PV
authors.lastname: Balint
authors.forename: George A
authors.initials: GA
authors.lastname: Bruyn
authors.forename: Andrea
authors.initials: A
authors.lastname: Delle Sedie
authors.forename: Emilio
authors.initials: E
authors.lastname: Filippucci
authors.forename: Jesus
authors.initials: J
authors.lastname: Garrido
authors.forename: Hilde B
authors.initials: HB
authors.lastname: Hammer
authors.forename: Annamaria
authors.initials: A
authors.lastname: Iagnocco
authors.forename: David
authors.initials: D
authors.lastname: Kane
authors.forename: Gurjit S
authors.initials: GS
authors.lastname: Kaeley
authors.forename: Helen
authors.initials: H
authors.lastname: Keen
authors.forename: Peter
authors.initials: P
authors.lastname: Mandl
authors.forename: Esperanza
authors.initials: E
authors.lastname: Naredo
authors.forename: Carlos
authors.initials: C
authors.lastname: Pineda
authors.forename: Bernd
authors.initials: B
authors.lastname: Schicke
authors.forename: Ralf
authors.initials: R
authors.lastname: Thiele
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: D'Agostino
authors.forename: Wolfgang A
authors.initials: WA
authors.lastname: Schmidt
mesh_terms: D000368:Aged; D003697:Delphi Technique; D003718:Denmark; D005260:Female; D006073:Gout / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012494:Sampling Studies; D012720:Severity of Illness Index; D014463:Ultrasonography; D014528:Uricosuric Agents / Q000627:therapeutic use
chemical_list: D014528:Uricosuric Agents
keywords: EXERCISE; GOUT; OMERACT; RELIABILITY; ULTRASONOGRAPHY