ABSTRACT
The aim of this study was to evaluate the reliability of the outcome measures in rheumatology (OMERACT) definitions for ultrasound (US) elementary lesions in gout through an image reading exercise. Images from patients with gout (static images and videos) were collected. As an initial step, we carried out a image reading exercise within the experts of the Pan-American League of Associations for Rheumatology (PANLAR) US Study Group (n = 16). The following step consisted in a web-based exercise with the participation of larger number of sonographers (n = 63) from different centers. Images were rated evaluating the presence/absence of any US elementary lesion. Inter- and intra-reader reliabilities were analyzed using kappa coefficients. Participants were stratified according to their level of experience. In the first exercise, inter-reader kappa values were 0.45 for aggregates, 0.57 for tophus, 0.69 for erosions, and 0.90 for double contour (DC). Intra-reader kappa values were 0.86, 0.76, 0.80, and 0.90, respectively. The web-based exercise showed inter-reader kappa values for aggregates, tophus, erosions, and DC of 0.42, 0.49, 0.69, and 0.79, respectively. The intra-reader kappa values were 0.62, 0.69, 0.77, and 0.85, respectively. Reliability was not influenced by the sonographer's level of experience. The reliability of the new OMERACT US definitions for elementary lesions in gout ranged from moderate to excellent, depending on the type of lesion.
Subject(s)
Gout/diagnostic imaging , Cross-Sectional Studies , Humans , Reproducibility of Results , UltrasonographyABSTRACT
El síndrome del túnel carpiano puede manifestarse con lesiones cutáneas. Estas pueden plantear el diagnóstico diferencial con una vasculitis. El compromiso del sistema nervioso simpático perivascular y los traumatismos a repetición secundarios a la hipoestesia son probablemente parte del mecanismo de daño. En este caso, se plantea además el papel patogénico de una arteria mediana remanente asociada a nervio mediano bífido (AU)
Carpal tunnel syndrome may present with skin lesions. This may lead to a differential diagnosis with vasculitis. Sympathetic nervous system perivascular involvement and recurrent injuries secondary to sensory loss are probably part of the mechanism of injury. In this case, we also comment on the pathogenic role of persistent median artery associated with a bifid median nerve (AU)
Subject(s)
Humans , Female , Aged, 80 and over , Carpal Tunnel Syndrome/pathology , Carpal Tunnel Syndrome , Vasculitis/complications , Vasculitis/diagnosis , Autonomic Nervous System Diseases/complications , Autonomic Nervous System Diseases/diagnosis , Electromyography/methods , Electromyography , Adrenal Cortex Hormones/therapeutic use , Immunosuppressive Agents/therapeutic use , Vasculitis , Diagnosis, Differential , Longitudinal Studies/methods , Longitudinal StudiesABSTRACT
Carpal tunnel syndrome may present with skin lesions. This may lead to a differential diagnosis with vasculitis. Sympathetic nervous system perivascular involvement and recurrent injuries secondary to sensory loss are probably part of the mechanism of injury. In this case, we also comment on the pathogenic role of persistent median artery associated with a bifid median nerve.
