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SAT0631 Inter-observer and intra-observer reliability of the omeract ultrasonographic (US) criteria for the diagnosis of calcium pyrophosphate deposition disease (CPPD) at the metacarpal-phalangeal (MCP), wrist, acromion-clavicular (AC) and hip joints
  1. G Filippou1,
  2. CA Scirè2,
  3. N Damjanov3,
  4. A Adinolfi1,
  5. G Bruyn4,
  6. G Carrara5,
  7. T Cazenave6,
  8. M-A D'Agostino7,
  9. A Delle Sedie8,
  10. ME Diaz Cortes9,
  11. E Filippucci10,
  12. F Gandjbakhch11,
  13. M Gutierrez12,
  14. D MacCarter13,
  15. M Micu14,
  16. I Moller15,
  17. G Mouterde16,
  18. MA Mortada17,
  19. E Naredo18,
  20. V Picerno1,
  21. C Pineda12,
  22. F Porta19,
  23. AM Reginato20,
  24. I Satulu21,
  25. WA Schmidt22,
  26. T Serban23,
  27. L Terslev24,
  28. V Vlad25,
  29. F Vreju26,
  30. P Zufferey27,
  31. S Bellavia1,
  32. P Bozios28,
  33. V Di Sabatino1,
  34. C Toscano1,
  35. A Iagnocco29,
  36. on behalf of OMERACT US subtask force in CPPD
  1. 1University of Siena, Siena
  2. 2University of Ferrara, Ferrara, Italy
  3. 3University of Belgrade, Belgrade, Serbia
  4. 4Department of Rheumatology, MC Groep, Lelystad, Netherlands
  5. 5SIR Epidemiology Unit, Milan, Italy
  6. 6Instituto de Rehabilitaciόn Psicofísica, Buenos Aires, Argentina
  7. 7Université Versailles Saint-Quentin en Yvelines, Paris, France
  8. 8University of Pisa, Pisa, Italy
  9. 9Fundacion Santa Fe de Bogotà, Bogotà, Colombia
  10. 10Università Politecnica delle Marche, Jesi, Italy
  11. 11Hôpital la Pitié Salpêtrière, Paris, France
  12. 12Instituto Nacional de Rehabilitaciόn, Mexico City, Mexico
  13. 13North Valley Hospital, MT, United States
  14. 14Rehabilitation Clinical Hospital, Cluj-Napoca, Romania
  15. 15InstitutoPoal, Barcellona, Spain
  16. 16Centre Hospitalier Universitaire de Montpellier, Montpellier, France
  17. 17Zagazig University, Zagazig, Egypt
  18. 18Hospital GU Gregorio Marañόn, Madrid, Spain
  19. 19Hospital of Pistoia, Pistoia, Italy
  20. 20Brown University, RI, United States
  21. 21Kalmar County Hospital, Kalmar, Sweden
  22. 22Immanuel Krankenhaus Berlin, Berlin, Germany
  23. 23Cantacuzino Hospital, Bucharest, Romania
  24. 24Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark
  25. 25Sf. Maria Hospital, Bucharest
  26. 26University of Medicine and Pharmacy Craiova, Doja, Romania
  27. 27Lausanne University Hospital, Lausanne, Switzerland
  28. 28University of Ioannina, Ioannina, Greece
  29. 29University of Turin, Turin, Italy


Background The OMERACT US subtask force “US in CPPD” recently created the definitions for US identification of crystal deposits in joints and tested the reliability at the knee [1].

Objectives To assess the inter/intra-observer reliability of US on detecting CPPD at triangular fibrocartilage complex (TFCC) of the wrists, fibrocartilage of the AC joint, hip labrum (HL), hyaline cartilage (HC) of the metacarpal (MC) and femoral head.

Methods The OMERACT criteria for CPPD were used for the exercise [1] using a 2 steps approach. First, the panel of experts gave a dichotomous score (presence/absence of CPPD) of 120 images of the sites included, using a web platform. The images were evaluated twice to assess the inter/intra-observer reliability. Then, the experts met in Siena for a patient based exercise. Bilateral evaluation of TFCC, AC, HL /HC of the hip and HC of the II-III MCP of 8 patients was carried out twice in a day, using a dichotomous score for CPPD. 8 US machines (3 GE, 1 Samsung and 4 Esaote) equipped with high resolution linear probes were used.

Results Reliability values of static exercise were high for all sites, demonstrating that definitions were clear. The results of the second step are presented in table 1. On live scanning, the TFCC resulted the most reliable site for CPPD assessment, followed by AC. Other sites demonstrated lower kappa values and thus are not reliable for CPPD assessment.

Conclusions TFCC of the wrist is the most reliable site for CPPD. By adding these results to the previous [2], we confirm that the OMERACT definitions for CPPD can be applied reliably at the knee (meniscus and HC), TFCC and AC, usually the most involved sites in CPPD. The next step of the OMERACT subtask force will be to test these findings in a longitudinal observational study.


  1. Filippou G, Scirè CA, Damjanov N et al. Definition and reliability assessment of elementary US findings in CPPD. Results of an international multi-observer study by the OMERACT sub-task force “US in CPPD”. J Rheumatol, in press.


Disclosure of Interest None declared

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