E Cipolletta1, G Filippou2, C A Scirè3, A Di Matteo4, J Di Battista5, F Salaffi6, W Grassi7, E Filippucci8. 1. Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy. Electronic address: edoardocipolletta@gmail.com. 2. Rheumatology Unit, ASST Fatebenefratelli "Luigi Sacco" University Hospital, Milan, Italy. Electronic address: gf.filippou@gmail.com. 3. Section of Rheumatology, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliero-Universitaria Sant'Anna di Cona, Ferrara, Italy. Electronic address: c.scire@reumatologia.it. 4. Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom. Electronic address: andrea.dimatteo@hotmail.com. 5. Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy. Electronic address: jacopeta@gmail.com. 6. Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy. Electronic address: faustosalaffi@gmail.com. 7. Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy. Electronic address: walter.grassi@univpm.it. 8. Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy. Electronic address: emilio_filippucci@yahoo.it.
Abstract
OBJECTIVE: To examine and compare the accuracy of conventional radiography (CR) and musculoskeletal ultrasonography (US) in the diagnosis of calcium pyrophosphate (CPP) crystals deposition disease (CPPD). DESIGN: A systematic search of electronic databases (PubMed, Embase, and Cochrane), conference abstracts and reference lists was undertaken. Studies which evaluated the accuracy of CR and/or US in the diagnosis of CPPD, using synovial fluid analysis (SFA), histology or classification criteria as reference tests were included. Subgroup analyses by anatomic site and by reference test were performed. RESULTS: Twenty-six studies were included. Using SFA/histology as reference test, CR and US showed an excellent (CR AUC = 0.889, 95%CI = 0.811-0.967) and an outstanding (US AUC = 0.954, 95%CI = 0.907-1.0) diagnostic accuracy (p < 0.01), respectively. Furthermore, US showed a higher sensitivity (0.85, 95%CI = 0.79-0.90 vs 0.47, 95%CI = 0.40-0.55) and only a little lower specificity (0.87, 95%CI = 0.83-0.91 vs 0.95, 95%CI = 0.92-0.97) than CR. A considerable heterogeneity between the studies was found, with adopted reference test being the main source of heterogeneity. In fact, subgroup analysis showed a significant change in the diagnostic accuracy of CR, but not of US, using Ryan and McCarty criteria or SFA/histology as reference test (CR: AUC = 0.956, 95%CI = 0.925-1.0 vs AUC = 0.889, 95%CI = 0.828-0.950, respectively, p < 0.01) (US: AUC = 0.922, 95%CI = 0.842-1.0 vs AUC = 0.957, 95%CI = 0.865-1.0, respectively, p = 0.08) CONCLUSIONS: Although US is more sensitive and a little less specific than CR for identifying CPP crystals, both these two techniques showed a great diagnostic accuracy and should be regarded as complementary to each other in the diagnostic work-up of patients with CPPD.
OBJECTIVE: To examine and compare the accuracy of conventional radiography (CR) and musculoskeletal ultrasonography (US) in the diagnosis of calcium pyrophosphate (CPP) crystals deposition disease (CPPD). DESIGN: A systematic search of electronic databases (PubMed, Embase, and Cochrane), conference abstracts and reference lists was undertaken. Studies which evaluated the accuracy of CR and/or US in the diagnosis of CPPD, using synovial fluid analysis (SFA), histology or classification criteria as reference tests were included. Subgroup analyses by anatomic site and by reference test were performed. RESULTS: Twenty-six studies were included. Using SFA/histology as reference test, CR and US showed an excellent (CR AUC = 0.889, 95%CI = 0.811-0.967) and an outstanding (US AUC = 0.954, 95%CI = 0.907-1.0) diagnostic accuracy (p < 0.01), respectively. Furthermore, US showed a higher sensitivity (0.85, 95%CI = 0.79-0.90 vs 0.47, 95%CI = 0.40-0.55) and only a little lower specificity (0.87, 95%CI = 0.83-0.91 vs 0.95, 95%CI = 0.92-0.97) than CR. A considerable heterogeneity between the studies was found, with adopted reference test being the main source of heterogeneity. In fact, subgroup analysis showed a significant change in the diagnostic accuracy of CR, but not of US, using Ryan and McCarty criteria or SFA/histology as reference test (CR: AUC = 0.956, 95%CI = 0.925-1.0 vs AUC = 0.889, 95%CI = 0.828-0.950, respectively, p < 0.01) (US: AUC = 0.922, 95%CI = 0.842-1.0 vs AUC = 0.957, 95%CI = 0.865-1.0, respectively, p = 0.08) CONCLUSIONS: Although US is more sensitive and a little less specific than CR for identifying CPP crystals, both these two techniques showed a great diagnostic accuracy and should be regarded as complementary to each other in the diagnostic work-up of patients with CPPD.
Authors: Sara K Tedeschi; Fabio Becce; Tristan Pascart; Ali Guermazi; Jean-François Budzik; Nicola Dalbeth; Georgios Filippou; Annamaria Iagnocco; Minna J Kohler; Jean-Denis Laredo; Stacy E Smith; F Joseph Simeone; Janeth Yinh; Hyon Choi; Abhishek Abhishek Journal: Arthritis Care Res (Hoboken) Date: 2022-04-19 Impact factor: 5.178
Authors: Sara K Tedeschi; Tristan Pascart; Augustin Latourte; Cattleya Godsave; Burak Kundakci; Raymond P Naden; William J Taylor; Nicola Dalbeth; Tuhina Neogi; Fernando Perez-Ruiz; Ann Rosenthal; Fabio Becce; Eliseo Pascual; Mariano Andres; Thomas Bardin; Michael Doherty; Hang-Korng Ea; Georgios Filippou; John FitzGerald; Marwin Guitierrez; Annamaria Iagnocco; Tim L Jansen; Minna J Kohler; Frédéric Lioté; Mark Matza; Geraldine M McCarthy; Roberta Ramonda; Anthony M Reginato; Pascal Richette; Jasvinder A Singh; Francisca Sivera; Alexander So; Lisa K Stamp; Janeth Yinh; Chio Yokose; Robert Terkeltaub; Hyon Choi; Abhishek Abhishek Journal: Arthritis Care Res (Hoboken) Date: 2022-06-30 Impact factor: 5.178