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An OMERACT reliability exercise of inflammatory and structural abnormalities in patients with knee osteoarthritis using ultrasound assessment
  1. George AW Bruyn1,
  2. Esperanza Naredo2,
  3. Nemanja Damjanov3,
  4. Artur Bachta4,
  5. Paul Baudoin1,
  6. Hilde Berner Hammer5,
  7. Femke BG Lamers-Karnebeek6,
  8. Ingrid Moller Parera7,
  9. Bethan Richards8,
  10. Mihaela Taylor9,
  11. Ami Ben-Artzi9,
  12. Maria-Antonietta D'Agostino10,
  13. Jesus Garrido11,
  14. Annamaria Iagnocco12
  15. on behalf of the Ultrasound Task Force
    1. 1Department of Rheumatology, MC Groep Hospitals, Lelystad, The Netherlands
    2. 2Department of Rheumatology, Hospital GU Gregorio Marañón and Universidad Complutense, Madrid, Spain
    3. 3Institute of Rheumatology, University of Belgrade School of Medicine, Belgrade, Serbia
    4. 4Department of Internal Diseases and Rheumatology, Military Medical Hospital, Warsaw, Poland
    5. 5Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
    6. 6Bernhoven Ziekenhuis Uden and Radboudumc, Nijmegen, The Netherlands
    7. 7Instituto Poal de Reumatologia, Barcelona, Spain
    8. 8Institute of Rheumatology and Orthopaedics, Royal Prince Alfred Hospital, Sydney, Australia; Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
    9. 9Division of Rheumatology, UCLA, Santa Monica, California, USA
    10. 10Department of Rheumatology, Hôpital Ambroise Paré, APHP, Université Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France
    11. 11Social Psychology and Methodology Department, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
    12. 12Department of Rheumatology, University Hospital, Sapienza Universita di Roma, Rome, Italy
    1. Correspondence to George AW Bruyn, Department of Rheumatology, MC Groep Hospitals, Lelystad, 8333 AA, The Netherlands; gawbruyn{at}


    Objective To assess whether ultrasonography (US) is reliable for the evaluation of inflammatory and structural abnormalities in patients with knee osteoarthritis (OA).

    Methods Thirteen patients with early knee OA were examined by 11 experienced sonographers during 2 days. Dichotomous and semiquantitative scoring was performed on synovitis characteristics in various aspects of the knee joint. Semiquantitative scoring was done of osteophytes at the medial and lateral femorotibial joint space or cartilage damage of the trochlea and on medial meniscal damage bilaterally. Intra- and interobserver reliability were computed by use of unweighted and weighted κ coefficients.

    Results Intra- and interobserver reliability scores were moderate to good for synovitis (mean κ 0.67 and 0.52, respectively) as well as moderate to good for the global synovitis (0.70 and 0.50, respectively). Mean intra- and interobserver reliability κ for cartilage damage, medial meniscal damage and osteophytes ranged from fair to good (0.55 and 0.34, 0.75 and 0.56, 0.73 and 0.60, respectively).

    Conclusions Using a standardised protocol, dichotomous and semiquantitative US scoring of pathological changes in knee OA can be reliable.

    • Ultrasonography
    • Synovitis
    • Knee Osteoarthritis

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