Reliability of an Omeract Semiquantitative Scoring System and Imaging Atlas for the Assessment of Cartilage in Hand Osteoarthritis

Alexander Mathiessen¹, Hilde B Hammer², Lene Terslev³, George A. W. Bruyn⁴, Maria Antonietta D'Agostino⁵, Emilio Filippucci⁶, Ida Kristin Haugen⁷, Marion Kortekaas⁸, Peter Mandl⁹, Ingrid Moller¹⁰, Esperanza Naredo¹¹, Ruth Wittoek¹², Annamaria Iagnocco¹³ and Karen Ellegaard¹⁴, ¹Dept. of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, ²Rheumatology, Dept. of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, ³Copenhagen University Hospital at Glostrup, Copenhagen, Denmark, ⁴Rheumatology, MC Groep, Loenga, Netherlands, ⁵Department of Rheumatology, Assistance publique-Hôpitaux de Paris Ambroise Paré Hospital, Boulogne-Billancourt , Université Versailles Saint Quentin en Yvelines, Paris, France, ⁶Rheumatology Unit, Università Politecnica delle Marche, Jesi, Italy, ⁷Diakonhjemmet Hospital, Oslo, Norway, ⁸Dept. of Rheumatology, Leiden University Medical Center, Leiden, Netherlands, ⁹Department of Internal Medicine III; Division of Rheumatology, Medical University Vienna, Vienna, Austria, ¹⁰Instituto de Poal, Barcelona, Spain, ¹¹Rheumatology Department, Hospital Gregorio Marañón, Madrid, Spain, ¹²Rheumatology, Ghent University Hospital, Ghent, Belgium, ¹³Academic Rheumatology Unit, Università degli Studi di Torino, Torino, Italy, ¹⁴Dept. of Rheumatology, The Parker Institute, Copenhagen, Denmark

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Imaging, osteoarthritis and ultrasonography

Session Information

Date: Sunday, November 5, 2017

Title: Imaging of Rheumatic Diseases Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

Osteoarthritis (OA) is characterized by gradual loss of articular cartilage. Evaluation of cartilage in the small joints of the hands has shown that ultrasound may differentiate between normal and pathological joint cartilage, whereas semiquantitative scoring is not reliable. These studies have however assessed the dorsal aspects of the joint, in which osteophytes often limits the acoustic window.

The aim of the present study was to test the reliability of a semiquantitative scoring system for the assessment of palmar finger joint cartilage by ultrasound in a patient-based exercise of patients with hand OA.

Methods:

Six experienced sonographers participated in a patient-based reliability exercise. Bilateral proximal interphalangeal (PIP) joints of 12 patients with hand OA were assessed twice on the same day by all experts using ultrasound machines (GE Logiq E9) equipped with high-frequency transducers (18MHz) with presets calibrated for the appropriate assessment of cartilage. The palmar aspects of the joints were assessed in a transverse view with the fingers fully extended, and the participants had an imaging atlas available during the exercise (figure).

Intraclass correlation coefficient (ICC) values with 95% confidence intervals (CI) were calculated with average-measure for inter-reader and single-measure for intra-reader reliability. Reliability was defined as poor (<0.5), moderate (0.5–0.75), good (0.75–0.9) and excellent (>0.90).

Results:

A three-grade semiquantitative was applied: grade 0, normal cartilage (anechoic structure with visible margins of cartilage); grade 1, focal thinning of cartilage or loss of sharpness of at least one cartilage margin; grade 2, focal or complete loss of cartilage. In total 96 joints were assessed twice by every sonographer. The inter-reader reliability was excellent (ICC=0.90, 95% CI 0.77–0.97). Intra-reader reproducibility was excellent (0.95, 0.83–0.98) to moderate (0.56, 0.02–0.85), with a mean ICC value of 0.74.

Conclusion:

A semiquantitative scoring system for the assessment of joint cartilage in palmar aspects of PIP joints by ultrasound showed excellent inter- and moderate to excellent intra-reader reliability in a patient-based reliability study. Our study demonstrates that ultrasound with a high-frequency probe is a reliable tool for evaluating cartilage and supports the use of a new semiquantitative scoring system for assessment of finger cartilage in hand OA patients.

Figure

Disclosure: A. Mathiessen, None; H. B. Hammer, None; L. Terslev, None; G. A. W. Bruyn, None; M. A. D'Agostino, None; E. Filippucci, None; I. K. Haugen, None; M. Kortekaas, None; P. Mandl, None; I. Moller, None; E. Naredo, None; R. Wittoek, None; A. Iagnocco, None; K. Ellegaard, None.

To cite this abstract in AMA style:

Mathiessen A, Hammer HB, Terslev L, Bruyn GAW, D'Agostino MA, Filippucci E, Haugen IK, Kortekaas M, Mandl P, Moller I, Naredo E, Wittoek R, Iagnocco A, Ellegaard K. Reliability of an Omeract Semiquantitative Scoring System and Imaging Atlas for the Assessment of Cartilage in Hand Osteoarthritis [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/reliability-of-an-omeract-semiquantitative-scoring-system-and-imaging-atlas-for-the-assessment-of-cartilage-in-hand-osteoarthritis/. Accessed .

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