Recommendation 3: Summary of included studies comparing imaging and CE in the detection of joint inflammation
| Ultrasound 29 studies, mean no. of subjects (range): 40.7 (6–100) | MRI 16 studies, mean no. of subjects (range): 47.3 (6–318) | Scintigraphy 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) MRI vs CE | Detection rate, mean (range) Scintigraphy vs CE | |||
| Synovitis18–24 | 2.18-fold (0.55–8.96-fold) | MRI synovitis, vs clinical synovitis21–24 37–40 | 2.20-fold (0.58–5.43-fold) accuracy: 0.72 | vs tenderness/swelling 45 46 | 1.19-fold Validity: 0.45 Coefficient of association: −0.16 |
| vs pain41 | 0.71-fold κ: 0.36, p 0.009 | vs tenderness41 | 0.70-fold κ: 0.32, p 0.008 | ||
| vs swelling41 | 1.36-fold κ: 0.60, p 0.019 | vs swelling41 | 1.33-fold κ: 0.64, p 0.023 | ||
| Correlation with DAS2842 | r 0.30–0.40 p<0.01 | ||||
| Tenosynovitis25 | 1.06-fold | Relative efficacy for tenosynovitis26 | 2.48–4.69 | ||
| Relative efficacy of Ultrasound at detecting any inflammation vs TJC26 | 0.61–1.33 | Relative efficacy of MRI synovitis vs TJC26 | 3.03–3.86 | ||
| Ultrasound foot/ankle vs CE | MRI foot/ankle vs CE | Scintigraphy feet vs CE | |||
| Effusion27 28 | 0.52–0.99-fold κ: 0.04–0.16 % agreement: 71% | vs tenderness/swelling45 | 0.42-fold | ||
| Inflammation29 | 2.21-fold % agreement: 63% | ||||
| Synovitis30 | 0.87-fold | Synovitis29 30 40 43 | 1.71-fold (0.93–2.8-fold) % agreement: 45.5–71% | ||
| Tenosynovitis30 | 0.58-fold | Tenosynovitis30 | % agreement: 54.5–90.9% | ||
| Ultrasound knees vs CE | MRI knees vs CE | Scintigraphy knees vs histology | |||
| Baker's cyst31–33 | 1.88-fold (1.17–2.5-fold) | Synovitis vs clinical synovitis44 | 1.6–3.15-fold | vs histology47 | 1.11-fold |
| Suprapatellar bursitis33 | 1.7-fold | Swelling vs histology47 | 0.72-fold | ||
| Effusion34 | 1.27-fold (1.17–1.4-fold) | ||||
| Synovitis vs clinical synovitis35 36 | r 0.9, p 0.0001 | ||||
| vs DAS28 | Strong correlation, p 0.006 | ||||
| vs SJC | Weak correlation, p 0.038 | ||||
CE, clinical examination; DAS28, disease activity score in 28 joints; TJC, tender joint count; SJC, swollen joint count.