Development of an Ultrasound Imaging Atlas for Grading Osteoarthritis in the First Metatarsophalangeal Joint

IF 3.7 2区 医学 Q1 RHEUMATOLOGY Arthritis Care & Research Pub Date : 2024-07-22 DOI:10.1002/acr.25407
Prue Molyneux, Catherine Bowen, Richard Ellis, Keith Rome, Kate Fitzgerald, Phillip Clark, Jackie L. Whittaker, Charlotte Dando, Richard Gee, Matthew Carroll
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Abstract

Objective

Ultrasound (US) imaging may play a fundamental role in the earlier detection and assessment of first metatarsophalangeal joint (MTPJ) osteoarthritis (OA) because of its ability to depict tissue-specific morphologic changes before the point of irreversible structural damage. However, the role of US in supporting the diagnosis of OA in foot joints has not been clearly defined. The aims of this study were to develop a semiquantitative US atlas (the AUT ultrasound imaging [AUTUSI] atlas) to grade the degree of osteoarthritic change in the first MTPJ and to evaluate the intraexaminer and interexaminer reproducibility of using the atlas.

Methods

US images were obtained from 57 participants (30 participants with radiographically confirmed first MTPJ OA). The AUTUSI atlas supports the examination of grading joint effusion, synovial hypertrophy, synovitis, osteophytes, joint space narrowing, and cartilage thickness. Six examiners used the atlas to independently grade 24 US images across 2 sessions. Intraexaminer and interexaminer reproducibility were determined using percentage agreement and Gwet's AC2.

Results

Observations using the AUTUSI atlas demonstrated almost perfect-to-perfect interexaminer agreement (percentage agreement ranged from 96% to 100%, and Gwet's AC2 values ranged from 0.81 to 1.00) and moderate-to-perfect intraexaminer agreement (percentage agreement ranged from 67% to 100%, and Gwet's AC2 values ranged from 0.54 to 1.00).

Conclusion

The AUTUSI atlas demonstrated excellent intraexaminer and interexaminer reproducibility for evaluating first MTPJ joint effusion, synovial hypertrophy, synovitis, joint space narrowing, osteophytes, and cartilage thickness. The AUTUSI atlas affords an opportunity to detect prognostic markers of OA earlier in the disease cascade and has the potential to advance understanding of the pathologic process of first MTPJ OA.

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开发用于第一跖趾关节骨关节炎分级的超声波成像图谱(AUTUSI 图谱)。
目的:超声波(US)成像可在第一跖趾关节(MTPJ)骨关节炎(OA)发生不可逆转的结构性损伤之前描述组织特异性形态变化,因此在早期发现和评估第一跖趾关节骨关节炎(OA)方面可发挥重要作用。然而,US 在支持足关节 OA 诊断方面的作用尚未得到明确界定。本研究的目的是开发一种半定量的 US 图谱(AUTUSI 图谱),用于分级第一 MTPJ 骨关节炎变化的程度,并评估检查者内部和检查者之间使用该图谱的可重复性:设计:从 57 名参与者(30 名参与者经影像学证实患有第一 MTPJ OA)处获取超声波图像。AUTUSI 图集支持对关节积液、滑膜肥厚、滑膜炎、骨质增生、关节间隙狭窄和软骨厚度进行分级检查。六位检查员在两次检查中使用图谱对 24 张超声图像进行了独立分级。使用一致性百分比和 Gwet's AC2 测定检查者内部和检查者之间的再现性:结果:使用 AUTUSI 图集进行的观察显示,检查者之间的一致性几乎完美无缺(一致性百分比从 96% 到 100% 不等,Gwet's AC2 值从 0.81 到 1.00 不等),检查者内部的一致性中度完美无缺(一致性百分比从 67% 到 100% 不等,Gwet's AC2 值从 0.54 到 1.00 不等):AUTUSI 图谱在评估第一 MTPJ 关节积液、滑膜肥厚、滑膜炎、关节间隙狭窄、骨质增生和软骨厚度方面显示出极佳的检查者内部和检查者之间的可重复性。AUTUSI 图集为在疾病发生的早期检测 OA 的预后标志物提供了机会,并有可能促进对第一 MTPJ OA 病理过程的了解。
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来源期刊
CiteScore
9.40
自引率
6.40%
发文量
368
审稿时长
3-6 weeks
期刊介绍: Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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