Johannes Roth1, Viviana Ravagnani2, Marina Backhaus3, Peter Balint4, Alessandra Bruns5, George A Bruyn6, Paz Collado7, Lorenia De la Cruz8, Severine Guillaume-Czitrom9, Troels Herlin10, Cristina Hernandez11, Annamaria Iagnocco12, Sandrine Jousse-Joulin13, Stefano Lanni14, Vibke Lilleby15, Clara Malattia14, Silvia Magni-Manzoni16, Consuelo Modesto17, Ana Rodriguez18, Juan-Carlos Nieto19, Sarah Ohrndorf20, Linda Rossi-Semerano9, Anne-Marit Selvaag21, Nanno Swen22, Tracy V Ting23, Nikolay Tzaribachev24, Patricia Vega-Fernandez25, Jelena Vojinovic26, Daniel Windschall27, Maria-Antonietta D'Agostino28, Esperanza Naredo19. 1. Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada. 2. ASST Mantova, C. Poma Hospital, Mantova, Italy. 3. Park-Klinik Weissensee, Berlin, Germany. 4. National Institute of Rheumatology and Physiotherapy, Budapest, Hungary. 5. Centre Hospitalier de l'Université de Sherbrooke, Sherbrooke, Quebec, Canada. 6. MC Groep Hospitals, Lelystad, The Netherlands. 7. Hospital Universitario Severo Ochoa, Madrid, Spain. 8. Hospital Universitario Universidad Autonoma de Nuevo Leon-Monterrey, Nuevo Leon, Mexico. 9. Bicetre University Hospital, Le Kremlin Bicetre, France. 10. Aarhus University Hospital, Aarhus, Denmark. 11. Instituto Nacional de Rehabilitacion, Mexico City, Mexico. 12. Università degli Studi di Torino, Turin, Italy. 13. Hôpital de la Cavale Blanche, Brest, France. 14. Istituto Giannina Gaslini, Genoa, Italy. 15. Rikshospitalet University Hospital, Oslo, Norway. 16. Ospedale Pediatrico Bambino Gesu, Rome, Italy. 17. Vall d'Hebron University Hospital, Barcelona, Spain. 18. Hospital Universitario Ramon y Cajal, Madrid, Spain. 19. Hospital General Universitario Gregorio Marañón, Madrid, Spain. 20. Charité University Hospital, Berlin, Germany. 21. Oslo University Hospital, Rikshospitalet, Oslo, Norway. 22. Medisch Centrum Alkmaar, Alkmaar, The Netherlands. 23. Cincinnati Children's Hospital, Cincinnati, Ohio. 24. Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany. 25. Emory University, Atlanta, Georgia. 26. University Clinical Center, Nis, Serbia. 27. Asklepios Hospital Weissenfels, Weissenfels, Germany. 28. Ambroise Paré Hospital, Boulogne-Billancourt and INSERM U1173, Laboratoire d'Excellence INFLAMEX, University Paris Ouest-Versailles St.-Quentin, Saint Quentin en Yvelines, France.
Abstract
OBJECTIVE: Musculoskeletal ultrasonography (US) has the potential to be an important tool in the assessment of disease activity in childhood arthritides. To assess pathology, clear definitions for synovitis need to be developed first. The aim of this study was to develop and validate these definitions through an international consensus process. METHODS: The decision on which US techniques to use and the components to be included in the definitions, as well as the final wording, were developed by 31 US experts in a consensus process. A Likert scale of 1-5 (where 1 = complete disagreement and 5 = complete agreement) was used. A minimum of 80% of the experts scoring 4 or 5 was required for final approval. The definitions were then validated on 120 standardized US images of the wrist, metacarpophalangeal joints, and tibiotalar joints, displaying various degrees of synovitis at various ages. RESULTS: B-mode and Doppler should be used for assessing synovitis in children. A US definition of the various components (i.e., synovial hypertrophy, effusion, and Doppler signal within the synovium) was developed. The definition was validated on still images with a median of 89% of participants (range 80-100) scoring it as 4 or 5 on a Likert scale. CONCLUSION: US definitions of synovitis and its elementary components covering the entire pediatric age range were successfully developed through a Delphi process and validated in a web-based still-images exercise. These results provide the basis for the standardized US assessment of synovitis in clinical practice and research.
OBJECTIVE: Musculoskeletal ultrasonography (US) has the potential to be an important tool in the assessment of disease activity in childhood arthritides. To assess pathology, clear definitions for synovitis need to be developed first. The aim of this study was to develop and validate these definitions through an international consensus process. METHODS: The decision on which US techniques to use and the components to be included in the definitions, as well as the final wording, were developed by 31 US experts in a consensus process. A Likert scale of 1-5 (where 1 = complete disagreement and 5 = complete agreement) was used. A minimum of 80% of the experts scoring 4 or 5 was required for final approval. The definitions were then validated on 120 standardized US images of the wrist, metacarpophalangeal joints, and tibiotalar joints, displaying various degrees of synovitis at various ages. RESULTS: B-mode and Doppler should be used for assessing synovitis in children. A US definition of the various components (i.e., synovial hypertrophy, effusion, and Doppler signal within the synovium) was developed. The definition was validated on still images with a median of 89% of participants (range 80-100) scoring it as 4 or 5 on a Likert scale. CONCLUSION: US definitions of synovitis and its elementary components covering the entire pediatric age range were successfully developed through a Delphi process and validated in a web-based still-images exercise. These results provide the basis for the standardized US assessment of synovitis in clinical practice and research.
Authors: Derk Frederik Matthaus Avenarius; Charlotte Nusman; Clara Malattia; Laura Tanturri de Horatio; Karen Rosendahl; Mario Maas; Lil-Sofie Ording Müller Journal: Pediatr Radiol Date: 2018-05-08
Authors: Jonathan R Dillman; Soudabeh Fazeli Dehkordy; Ethan A Smith; Michael A DiPietro; Ramon Sanchez; Vera DeMatos-Maillard; Jeremy Adler; Bin Zhang; Andrew T Trout Journal: Pediatr Radiol Date: 2017-04-18
Authors: Patricia Vega-Fernandez; Tracy V Ting; Edward J Oberle; Courtney McCracken; Janet Figueroa; Mekibib Altaye; Amy Cassedy; Gurjit S Kaeley; Johannes Roth Journal: Arthritis Care Res (Hoboken) Date: 2021-07-30 Impact factor: 5.178