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Abstract Number: 226

Omeract Definitions For The Sonographic Appearance Of The Normal Pediatric Joint

Johannes Roth1, Sandrine Jousse-Joulin2, Silvia Magni-Manzoni3, Ana Narrodi4, Nikolay Tzaribachev5, Annamaria Iagnocco6, Esperanza Naredo7, Maria-Antonietta d'Agostino8 and Paz Collado9, 1University of Ottawa, Ottawa, ON, Canada, 2Rheumatology, CHU Brest, Brest, France, 3Ospedale Pediatrico Bambino Gesù, Roma, Italy, 4Rheumatology, Madrid, Spain, 5Pediatric Rheumatology, Center for Rheumatic Diseases, Bad Bramstedt, Germany, 6Sapienza University of Rome, Rome, Italy, 7Rheumatology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain, 8Rheumatology, Ambroise Paré Hospital, and Versailles Saint Quentin en Yvelines University, Boulogne-Billancourt, France, 9Rheumatology, Severo Ochoa University Hospital, Madrid, Spain

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Health, juvenile idiopathic arthritis (JIA) and ultrasonography

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Session Information

Title: Imaging of Rheumatic Diseases I: Imaging in Gout, Pediatric, Soft and Connective Tissue Diseases

Session Type: Abstract Submissions (ACR)

Background/Purpose: Musculoskeletal ultrasound (MSUS) has significant potential in the assessment of disease activity and early structural damage in childhood arthritides. In order to assess pathology, the ultrasonographic characteristics of the normal pediatric joint need to be defined first. The aims of this study were to develop definitions for the various components of the pediatric joint that can be evaluated by MSUS through a consensus process and to validate these definitions in their practical application.

Methods: In a first step, members of the pediatric group of the OMERACT Ultrasound Task Force developed definitions of the ultrasonographic appearance for various components of the pediatric joint through a Delphi process. In a second step, standardized scans of the knee and ankle joint were acquired on 4 healthy volunteers aged 12, 10 and 4 years old (2 volunteers) by seven members of the group on the same day. Subsequently, for each of the stored images, the applicability (validity) of each of the definitions was scored by all 7 participants on a 1-5 Likert scale. A minimum of 80 % grade 4 or 5 agreement across all images was required in order to validate the definition.

Results:

Five definitions were developed through the Delphi process addressing articular bone, cartilage, joint capsule, the epiphyseal ossification centre and the synovial membrane. A total of 224 images were acquired by the seven participants. 172 of these images were selected for analysis and on each of them the five definitions were rated by all 7 participants. In the first practical application on stored images the minimum of 80 % agreement was not met for either definition. After further modification of the definitions 95%, 81%, 86%, 97% and 91% agreement were reached respectively.

Conclusion:

In this study, definitions of the ultrasonographic appearance for the various components of the normal pediatric joint were successfully developed through a Delphi process and validated in a practical exercise. These results represent the essential first step in order to develop definitions for pathology and support the standardization of the ultrasonographic assessment of the pediatric joint. This carries relevant implications in defining the role of MSUS both in routine clinical assessment and as an outcome measure in research.


Disclosure:

J. Roth,
None;

S. Jousse-Joulin,
None;

S. Magni-Manzoni,
None;

A. Narrodi,
None;

N. Tzaribachev,
None;

A. Iagnocco,
None;

E. Naredo,
None;

M. A. d’Agostino,
None;

P. Collado,
None.

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