scholarly journals FRI0563 Musculoskeletal ultrasound (MSUS) is superior to clinical examination regarding detection of arthritis in patients with systemic sclerosis

2018 ◽  
Author(s):  
D. Feldmann ◽  
R.E. Voll ◽  
F. Kollert ◽  
S. Finzel
Keyword(s):  
Systemic Sclerosis ◽  
Clinical Examination ◽  
Musculoskeletal Ultrasound

A study of Madrid sonographicenthesis score Index (MASEI) versus spondyloarthritis research consortium of Canada (SPARCC) in the assessment of early enthesopathy among psoriatic skin patient

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nehal M Zytoon ◽  
Nadia S Abd El Bar ◽  
Mona G El Husseiny ◽  
Reem M El-mallah ◽  
Nermin H El-Gharbawy
Keyword(s):  
Clinical Examination ◽  
Power Doppler ◽  
Musculoskeletal Ultrasound ◽  
Psoriatic Skin ◽  
P Value ◽  
Early Assessment ◽  
Significant Difference ◽  
The Mean ◽  
Research Consortium ◽  
Score Index

Abstract Objective To compare between Sonographic Madrid score index (MASEI) versus Spondyloarthritis research consortium of canada (SPARCC) for early assessment of enthesopathy among psoriatic skin patients. Patients and Methods This study included fifty psoriatic skin patients. All underwent history, laboratory investigation, clinical examination using SPARCC score, Psoriasis Area and Severity Index (PASI) and musculoskeletal ultrasound using MASEI score with power Doppler (PD) bilaterally for assessment of enthesitis. Results The mean age of fifty patients was 42.00 ± 10.923 years, disease duration of 11.110 ±7.402 and BMI of 29.356 ± 3.753. The mean PASI was 12.950±8.044. SPARCC score was positive in 10 out of 50 patients (20%).MASEI score was positive in 20 out of 50 patients (40%) with 10 out of 50 patients had power Doppler signals. Highly statistically significant difference between MASEI and SPARCC score( pvalue <0.001). Highly statistically significant positive correlation was observed between PASI score and MASEI(r = 0.498, p-value <0.001). Conclusion musculoskeletal ultrasound is useful for early detection of enthesitis and to be a sensitive tool in detecting of enthesitis and subclinical enthesitis that can be missed during routine clinical examination.

Assessment of rheumatic disease

2013 ◽  
pp. 212-220
Author(s):  
Piet van Riel
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Sclerosis ◽  
Ankylosing Spondylitis ◽  
Rheumatic Diseases ◽  
Clinical Examination ◽  
Spinal Mobility ◽  
Diagnostic Process ◽  
Skin Involvement ◽  
Skin Score ◽  
Modified Rodnan Skin Score

The clinical examination of the musculoskeletal system is the cornerstone in the diagnostic process of rheumatic diseases. Next to this the clinical examination is important in evaluating the course of the different rheumatic diseases and the response to interventions. For instance in rheumatoid arthritis the joint scores—number of painful and swollen joints—are important in the evaluation of the disease activity of the patient. In systemic sclerosis the severity of skin involvement is measured with a skin score such as the modified Rodnan skin score, and in ankylosing spondylitis the spinal mobility is measured using different clinical scores. In general all these examinations should be carried out as far as possible in a standardized, systematic way.

scholarly journals Development of a Musculoskeletal Ultrasound Protocol to Examine Upper Extremity Rehabilitation Outcomes in Systemic Sclerosis

2020 ◽  
Vol 37 (1) ◽  
pp. 13-23
Author(s):  
Susan L. Murphy ◽  
Donnamarie Krause ◽  
Shawn C. Roll ◽  
Girish Gandikota ◽  
Mary Barber ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Interrater Reliability ◽  
Outcome Measurement ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Thickness Measurement ◽  
Musculoskeletal Ultrasound ◽  
Gray Scale ◽  
Strain Elastography ◽  
Rehabilitation Outcomes

Objectives: This study developed a musculoskeletal ultrasound (MSUS) protocol to evaluate rehabilitation outcomes in systemic sclerosis. Materials and Methods: Three MSUS methods (gray-scale, Doppler, strain elastography) and two acquisition techniques (long- vs short-axis; transducer on skin vs floating on gel) were examined in the forearm before and after rehabilitation treatment. For gray-scale, tissue thickness measures and intrarater and interrater reliability were calculated (intraclass correlation coefficients [ICCs]), and paired t tests examined differences among techniques. Results: Five people with diffuse cutaneous systemic sclerosis participated. The most valid and reliable gray-scale technique was with the transducer in long-axis, floating on gel. Doppler and strain elastography did not detect changes. Both dermal and subcutaneous thickness measurement error was small; intrarater and interrater reliability was good to excellent. Preliminary data indicate that treatment may lead to dermal thinning. Conclusion: A replicable protocol was established and may be an adjunct to rehabilitation outcome measurement in systemic sclerosis.

scholarly journals Musculoskeletal Ultrasound Objective Structured Clinical Examination: An Assessment of the Test

2013 ◽  
Vol 66 (1) ◽  
pp. 2-6 ◽  
Author(s):  
Eugene Y. Kissin ◽  
Peter C. Grayson ◽  
Amy C. Cannella ◽  
Paul J. DeMarco ◽  
Amy Evangelisto ◽  
...  
Keyword(s):  
Clinical Examination ◽  
Musculoskeletal Ultrasound ◽  
Objective Structured Clinical Examination

scholarly journals Reliability and Validity of the Tender and Swollen Joint Counts and the Modified Rodnan Skin Score in Early Diffuse Cutaneous Systemic Sclerosis: Analysis from the Prospective Registry of Early Systemic Sclerosis Cohort

2017 ◽  
Vol 44 (6) ◽  
pp. 791-794 ◽  
Author(s):  
Jessica K. Gordon ◽  
Gandikota Girish ◽  
Veronica J. Berrocal ◽  
Meng Zhang ◽  
Christopher Hatzis ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Content Validity ◽  
Reliability And Validity ◽  
Intraobserver Reliability ◽  
Musculoskeletal Ultrasound ◽  
Skin Score ◽  
Modified Rodnan Skin Score ◽  
Diffuse Cutaneous Systemic Sclerosis ◽  
Early Systemic Sclerosis

Objective.To determine the inter/intraobserver reliability of the tender and swollen joint counts (TJC, SJC) and the modified Rodnan Skin Score (mRSS) in diffuse cutaneous systemic sclerosis (dcSSc) and to assess content validity of the TJC/SJC.Methods.Ten rheumatologists completed the SJC, TJC, and mRSS on 7 patients. Musculoskeletal ultrasound (MSUS) was performed.Results.Interobserver and intraobserver reliability for the TJC was 0.97 and 0.99, for the SJC was 0.24 and 0.71, and for the mRSS was 0.81 and 0.94, respectively. MSUS abnormalities did not correspond with SJC/TJC.Conclusion.We demonstrate excellent inter- and intraobserver reliability for the mRSS and TJC in dcSSc. However, the SJC and TJC did not correspond to MSUS.

scholarly journals POS1094 SYNOVITIS IS FACTOR OF OSTEOARTHRITIS KNEE PROGRESSION IN PATIENTS WITH LESS THAN 5 YEARS OF DISEASE DURATION

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 827.1-827
Author(s):  
L. Alekseeva ◽  
N. Kashevarova ◽  
E. Taskina ◽  
D. Kusevich
Keyword(s):  
Knee Pain ◽  
Clinical Examination ◽  
Disease Duration ◽  
Radiographic Progression ◽  
Musculoskeletal Ultrasound ◽  
Knee Joints ◽  
X Ray ◽  
Knee Oa ◽  
Radiological Stage

Background:There are many studies about investigation of risk factors (RF) of knee osteoarthritis (OA) radiologic progression. Especially, in patients with small disease duration. At the moment, there are ambivalent of results of previous studies, lead to uncertain role of synovitis.Objectives:The aim of study is to investigate relationship between knee OA synovitis and progression risk in patients with small disease duration during a follow-up period of 5 years.Methods:Eligible patients had knee OA based on ACR criteria with x-ray confirmation; baseline (BL) disease duration less than 5 years. Patients were evaluated at BL and at 5-year follow-up, using the questionnaires, clinical examination, knee joints pain by visual analog scale (VAS), musculoskeletal ultrasound and X-ray. Unadjusted p-values are presented.Results:Among 52 adults with knee OA (mean age ± standard deviation, 59.11 ± 8.95 years; 100% female) had the proportion of patients at BL 42.3% (n=22), 46.2 % (n=24), 11.5% (n=6) by disease stage 1,2 and 3, respectively. Patients were categorized into 2 groups by progression during 5 years from BL based on changes of radiological stage. After 5-years follow-up period the progression of knee OA was established in 14 patients (1 group) and in 38 patients (2 group) the progression by radiological stage was absent. BL patients’ characteristics were similar across 1st and 2nd groups: mean age 58.29±7.68 vs 56.05±8.74, р>0.05; disease duration 3.43±1.34 vs 3.47±1.33, р>0.05. Individuals with knee OA progression had worse knee joints pain during walking (60.36±18.33 vs 48.71±17.81, р=0.043), higher body mass index (BMI) (34.45±4.60 vs 28.92±4.92 kg/m2, р=0.001), higher frequency of knee synovitis by clinical examination (42.9% vs 10.5%, RR=4.07; 95%Cl (1,3-12,3), р=0.01) and by musculoskeletal ultrasound (57.1% vs 18.4%, RR=3.1; 95%CI (1.38-6.96), р=0.009). At 5-years follow-up knee pain was significantly greater for 1st group (69.64±18,49 vs 55.76±12.76, р = 0.003), higher BMI (35.74±5.83 vs 30.64±4.64, р = 0.002), also higher frequency of knee synovitis by clinical examination (57.1% vs 10.5%, RR = 5.4 (95%Cl 1.9-15.2), р=0.001) and by musculoskeletal ultrasound (50% vs 13.2%, RR=3.8 (95%Cl 1.4-10.0), р=0.009). Spearman correlation coefficients between radiologic stage and OA progression factors were indicated: between radiologic stage and knee pain during walking (r = 0.34, p<0.05), BMI (r = 0.46, p<0.01), knee synovitis by musculoskeletal ultrasound (r = 0.41, p<0.01). Multivariate (discriminant) analysis was determined that synovitis is a significant predictor of radiographic progression (p < 0.05).Conclusion:The proportion of patients with knee synovitis by clinical examination and musculoskeletal ultrasound data increased by 5-year follow-up from BL. Synovitis is a significant predictor of radiographic progression of knee OA in patients with small disease duration.Disclosure of Interests:None declared.Figure 1.

scholarly journals AB0847 ESTABLISHMENT AND VALIDATION OF A DIDACTIC MUSCULOSKELETAL ULTRASOUND COURSE FOR DERMATOLOGISTS USING AN INNOVATIVE HANDHELD ULTRASOUND SYSTEM – THE MUDE STUDY (MUSCULOSKELETAL ULTRASOUND IN DERMATOLOGY)

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1447-1448
Author(s):  
J. Grobelski ◽  
F. Recker ◽  
D. Wilsmann-Theis ◽  
W. Hartung ◽  
P. Karakostas ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Clinical Examination ◽  
German Society ◽  
Musculoskeletal Ultrasound ◽  
Objective Structured Clinical Examination ◽  
Joint Effusion ◽  
Teaching Concept ◽  
Significant Difference ◽  
Handheld Ultrasound ◽  
Good Grade

Background:In the early detection of arthritis, such as psoriatic arthritis (PsA), ultrasound (US) of painful joints plays an important role in diagnosis. Pathological findings can be missed during clinical examination, especially if conducted by physicians who are not trained. Furthermore, several publications undermine the importance of early PsA detection in psoriasis patients and the key role of the dermatologists in this process.Objectives:The objective of this study was to examine a pilot musculoskeletal ultrasound (MSUS) course designed specifically for dermatologists.Methods:To assess the degree of US expertise of the participants, a questionnaire was conducted before the course. The course concept, based on The German Society for Ultrasound in Medicine (Deutsche Gesellschaft fur Ultraschall in der Medizin, DEGUM) covering only the most important US sections of all joints and focused on the detection of joint effusion and hyperperfusion. The course consisted of three modules and was carried out over 6 months. Figure 1 shows the modular course concept. A portable US device in combination with a tablet was provided to enable practice between the courses. The final teaching evaluation was carried out as an objective structured clinical examination (OSCE) consisting of three stations, each representing the three course modules. According to the following grade scoring system, the performance rating was checked: < 60 % failed, ≥ 60 - < 70 % sufficient, ≥ 70% - < 80 % satisfying, ≥ 80% - < 90 % good, ≥ 90 % very good.Results:Twelve dermatologists participated. The mean age of our cohort was 39 years (SD ± 9.99 years) with nine females (75 %). Eight were specialists in dermatology in mean for 11.4 years (SD ± 11 years). Four were assistant physicians practicing dermatology in mean for 3.06 years (SD ± 0.97 years).The survey revealed no prior knowledge of MSUS. The overall mean score of all participants in the OSCE was 21.86 (SD ± 2.12) (87.44%) out of a total of 25 points resulting in a good grade. There was no statistically significant difference between the assistant physicians and the specialists in dermatology regarding the OSCE results. Table 1 shows the OSCE results.Table 1.Objective structured clinical examination (OSCE) mean results for all three stationsOSCEstationsMean absoluteMean absoluteStandard DeviationMean percentageStandard DeviationConfidence IntervalGrade118.9218.92+/- 3.0775.67%+/-12.27%67.87-83.46%Sufficient223.8323.83+/-0.9995.33%+/-3.94%92.83-97.84%Very good322.8322.83+/-0.3791.33%+/-1.49%90.39-92.28%Very goodOSCE station 1-321.8621.86+/-2.1287.44%+/-8.49%66.36-108.53%GoodConclusion:The innovative US teaching concept was able to demonstrate, that it is appropriate for the training of dermatologists in MSUS, independently of their age, experience in dermatology and US.Disclosure of Interests:Jakub Grobelski: None declared, Florian Recker: None declared, Dagmar Wilsmann-Theis: None declared, Wolfgang Hartung: None declared, Pantelis Karakostas: None declared, Peter Brossart: None declared, Valentin Schäfer Speakers bureau: AbbVie, Novartis, BMS, Chugai, Celgene, Medac, Sanofi, Lilly, Hexal, Pfizer, Janssen, Roche, Schire, Onkowissen, Royal College London, Consultant of: Novartis, Chugai, AbbVie, Celgene, Sanofi, Lilly, Hexal, Pfizer, Amgen, BMS, Roche, Gilead, Medac, Grant/research support from: Novartis, Hexal, Lilly, Roche, Celgene, Universität Bonn

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