Abstract
Objective. Musculoskeletal ultrasound (MSUS) is increasingly being used in the evaluation of pediatric musculoskeletal diseases. In order to provide objective assessments of arthritis, reliable MSUS scoring systems are needed. Recently, joint-specific scoring systems for arthritis of the pediatric elbow, wrist, and finger joints were proposed by the Childhood Arthritis and Rheumatology Research Alliance (CARRA) MSUS workgroup. This study aimed to assess the reliability of these scoring systems when used by sonographers with different levels of expertise. Methods. Members of the CARRA MSUS workgroup attended training sessions for scoring the elbow, wrist, and finger. Subsequently, scoring exercises of B mode and power Doppler (PD) mode still images for each joint were performed. Interreader reliability was determined using 2-way single-score intraclass correlation coefficients (ICCs) for synovitis and Cohen κ for tenosynovitis. Results. Seventeen pediatric rheumatologists with different levels of MSUS expertise (1-15 yrs) completed a 2-hour training session and calibration exercise for each joint. Excellent reliability (ICC > 0.75) was found after the first scoring exercise for all the finger and elbow views evaluated on B mode and PD mode, and for all of the wrist views on B mode. After a second training session and a scoring exercise, the wrist PD mode views reached excellent reliability as well. Conclusion. The preliminary CARRA MSUS scoring systems for assessing arthritis of the pediatric elbow, wrist, and finger joints demonstrate excellent reliability among pediatric MSUS sonographers with different levels of expertise. With further validation, this reliable joint-specific scoring system could serve as a clinical tool and scientific outcome measure.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 236-239 |
| Number of pages | 4 |
| Journal | Journal of Rheumatology |
| Volume | 50 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2023 |
Funding
The authors wish to acknowledge Childhood Arthritis and Rheumatology Research Alliance (CARRA) and the ongoing Arthritis Foundation financial support of CARRA. This project was funded by a CARRA–Arthritis Foundation Small Grant. PVF was supported by the Center for Clinical and Translational Science and Training at the University of Cincinnati, which is funded by the National Institutes of Health (NIH) Clinical and Translational Science Award program (grant 2UL1TR001425-05A1 and KL2 [2KL2TR001426-05A]); the National Institutes of Arthritis and Musculoskeletal Skin Diseases (award no. P30AR076316); and the Diversity and Health Disparities Award, which is funded by Cincinnati Children’s Hospital Medical. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. 1P. Vega-Fernandez, MD, MSc, Y. Esteban, MD, M. Henrickson, MD, MPH, T.V. Ting, MD, MSc, Department of Pediatrics, University of Cincinnati, Division of Rheumatology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA; 2E. Oberle, MD, Nationwide Children’s Hospital, Columbus, Ohio, USA; 3J.P. Proulx-Gauthier, MD, FRCPC, Department of Pediatrics, CHU de Québec-Université Laval, Quebec City, Quebec, Canada; 4M. Clark, MD, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA; 5S. Shenoi, MBBS, MS, Seattle Children’s Hospital and Research Center University of Washington, Seattle, Washington, USA; 6A. Thatayatikom, MD, AdventHealth for Children, Orlando, Florida, USA; 7H. Benham, DNP, APRN, Scottish Rite for Children Dallas, Dallas, Texas, USA; 8E.J. Brunner, DO, Geisinger Medical Center, Danville, Pennsylvania, USA; 9L. Woolnough, MD, MSCS, Department of Pediatrics, UFHealth, Gainesville, Florida, USA; 10L.R. Pratt, MD, University of Nebraska Medical Center, Omaha, Nebraska, USA; 11D. De Ranieri, MD, Department of Pediatrics, Northwestern Feinberg School of Medicine, Division of Rheumatology, Ann and Robert H. Lurie Children’s Hospital, Chicago, Illinois, USA; 12S. Hoffmann, MD, Children’s Hospital of Richmond, Virginia, USA; 13G. Janow, MD, MPH, Joseph M. Sanzari Children’s Hospital, Hackensack, New Jersey, USA; 14H. Bukulmez, MD, Department of Pediatrics, Division of Pediatric Rheumatology, Metro Health Medical System, Case Western Reserve University, Cleveland, Ohio, USA; 15M. Altaye, PhD, A. Cassedy, PhD, Department of Pediatrics, University of Cincinnati, Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA; 16J. Roth, MD, PhD, FRCPC, Children’s Hospital Eastern Ontario, Ottawa, Ontario, Canada. Address correspondence to Dr. P. Vega-Fernandez, 3333 Burnet Ave, Cincinnati, OH 45229, USA. Email: [email protected]. Accepted for publication September 13, 2022.
Keywords
- diagnostic imaging
- juvenile idiopathic arthritis
- ultrasonography
ASJC Scopus subject areas
- Rheumatology
- Immunology and Allergy
- Immunology