Table 2

Recommendation 3: Summary of included studies comparing imaging and CE in the detection of joint inflammation

29 studies, mean no. of subjects (range): 40.7 (6–100)
16 studies, mean no. of subjects (range): 47.3 (6–318)
14 studies, mean no. of subjects (range): 22.6 (8–38)
Ultrasound hand/wrist vs CE (article reference)MRI hand/wrist vs CE (article reference)Scintigraphy hand/wrist vs CE (article reference)
Detection rate, mean (range)
Ultrasound vs CE
Detection rate, mean (range)
Detection rate, mean (range)
Scintigraphy vs CE
Synovitis18–242.18-fold (0.55–8.96-fold)MRI synovitis, vs clinical synovitis21–24 37–402.20-fold (0.58–5.43-fold)
accuracy: 0.72
vs tenderness/swelling 45 461.19-fold
Validity: 0.45
Coefficient of association: −0.16
vs pain410.71-fold
κ: 0.36, p 0.009
vs tenderness410.70-fold
κ: 0.32, p 0.008
vs swelling411.36-fold
κ: 0.60, p 0.019
vs swelling411.33-fold
κ: 0.64, p 0.023
Correlation with DAS2842r 0.30–0.40
Tenosynovitis251.06-foldRelative efficacy for tenosynovitis262.48–4.69
Relative efficacy of Ultrasound at detecting any inflammation vs TJC260.61–1.33Relative efficacy of MRI synovitis vs TJC263.03–3.86
Ultrasound foot/ankle vs CEMRI foot/ankle vs CEScintigraphy feet vs CE
Effusion27 280.52–0.99-fold
κ: 0.04–0.16
% agreement: 71%
vs tenderness/swelling450.42-fold
% agreement: 63%
Synovitis300.87-foldSynovitis29 30 40 431.71-fold (0.93–2.8-fold)
% agreement: 45.5–71%
Tenosynovitis300.58-foldTenosynovitis30% agreement: 54.5–90.9%
Ultrasound knees vs CEMRI knees vs CEScintigraphy knees vs histology
Baker's cyst31–331.88-fold (1.17–2.5-fold)Synovitis vs clinical synovitis441.6–3.15-foldvs histology471.11-fold
Suprapatellar bursitis331.7-foldSwelling vs histology470.72-fold
Effusion341.27-fold (1.17–1.4-fold)
Synovitis vs clinical synovitis35 36r 0.9, p 0.0001
vs DAS28Strong correlation, p 0.006
vs SJCWeak correlation, p 0.038
  • CE, clinical examination; DAS28, disease activity score in 28 joints; TJC, tender joint count; SJC, swollen joint count.