scholarly journals POS0497 A RELIABILITY EXERCISE USING CONSENSUAL DEFINITIONS FOR THE ULTRASONOGRAPHY OF THE SHOULDER IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 481.2-481
Author(s):  
K. Ben Abdelghani ◽  
S. Miladi ◽  
I. Mahmoud ◽  
H. Ajlani ◽  
E. Haddouche ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Shoulder Pain ◽  
Imaging Modality ◽  
Interobserver Reliability ◽  
Daily Practice ◽  
Musculoskeletal Radiology ◽  
Painful Shoulder ◽  
Imaging Tool ◽  
Precise Diagnosis ◽  
Long Head

Background:Although numerous clinical tests for the diagnosis of painful shoulder are available, differentiating articular from periarticular lesions may be difficult in daily practice. Fortunately, the precise diagnosis of shoulder pain in RA benefited from a reliable imaging modality to detect its exact origin as ultrasonography (US).Objectives:This study aimed to assess the intraobserver and interobserver reliabilities of the ultrasonographic findings for patients with established RA having shoulder pain in a patient-based exercise among maghrebian rheumatologists experts on US.Methods:A total of 7 operators examined 10 patients in 2 rounds independently and blindly of each other.Each patient underwent a US scanning of the painful shoulder in four sites based on US technical guidelines of the European society of musculoskeletal radiology: long head of Biceps (LHB), subscapularis recess, posterior recess and axillary recess. The presence of a subdeltoid or subcoracoid bursitis or the presence of transfixiant tear of the suprasupinatus were notified if present. Intra and inter-observer reliabilities were calculated.Results:Intraobserver reliability was excellent for GS synovitis in subscapularis and posterior recesses (k=0.91 for both) and for subcoracoid bursitis (k=0.81). It was good in case of presence of a subdeltoid bursitis (k=0.79), transfixiant tear of the suprasupinatus (k=0.65), GS synovitis and effusion in LHB (k=0.67 and 0.6 respectively) and subdeltoid bursitis (k= 0.79). Interobserver reliability was good for PD for LHB signals searched longitudinally (k=0.78) and transversally (k=0.78). It was moderate for GS for LHB synovitis (k=0.55). Interobserver agreement was poor for effusion and GS synovitis for subscapularis, posterior and axillary recesses. It was very poor and/or absent for PD signals in these recesses.Conclusion:US is a reliable imaging tool for shoulder in RA especially with regard to LHB effusion, GS and PD synovitis. Interobserver reliability of subscapularis, posterior and axillary recesses could be optimized by standardization of sites to assess.References:[1]Bruyn G a. W, Naredo E, Möller I, Moragues C, Garrido J, de Bock GH, et al. Reliability of ultrasonography in detecting shoulder disease in patients with rheumatoid arthritis. Ann Rheum Dis 2009;68:357–61.Disclosure of Interests:None declared

Ultrasound and contrast enhanced ultrasound imaging in the diagnosis of acute aortic pathologies

VASA ◽  
2019 ◽  
Vol 48 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Giovanna Negrão de Figueiredo ◽  
Katharina Müller-Peltzer ◽  
Vincent Schwarze ◽  
Johannes Rübenthaler ◽  
Dirk-André Clevert
Keyword(s):  
Contrast Media ◽  
Ultrasound Imaging ◽  
Imaging Modality ◽  
Endovascular Aneurysm Repair ◽  
Cost Effective ◽  
Daily Practice ◽  
Contrast Enhanced Ultrasound ◽  
Imaging Tool ◽  
Contrast Enhanced ◽  
Aortic Pathologies

Abstract. Conventional ultrasound is worldwide the first-line imaging modality for the prompt diagnosis in the daily practice because it is a cost-effective and easy to perform technique. The additional application of contrast media has been used to enhance the intravascular contrast and to improve the imaging diagnostic accuracy in the detection, classification and follow-up of vascular pathologies. Contrast-enhanced ultrasound has the advantage of being a safe, fast and dynamic non-invasive imaging tool with excellent results in the diagnosis of acute aortic pathologies, especially the detection of endoleaks after endovascular aneurysm repair. This review describes the diagnostic and therapeutic roles of ultrasound and contrast-enhanced ultrasound imaging in the most common vascular pathologies such as aortic dissections, aneurysms and endoleaks. Keywords: Endoleak, contrast media, ultrasonography, aorta

scholarly journals OP0178 IMAGING NEOANGIOGENESIS IN RHEUMATOID ARTHRITIS (INIRA): WHOLE-BODY SYNOVIAL UPTAKE OF A 99MTC-LABELLED RGD PEPTIDE IS HIGHLY CORRELATED WITH POWER DOPPLER ULTRASOUND

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 110.2-111
Author(s):  
L. Attipoe ◽  
S. Subesinghe ◽  
C. Blanco-Gil ◽  
M. Opena ◽  
M. Rosser ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Correlation Coefficient ◽  
Doppler Ultrasound ◽  
Imaging Modality ◽  
Power Doppler ◽  
Whole Body ◽  
Total Power ◽  
Acquisition Time ◽  
Power Doppler Ultrasound ◽  
Highly Correlated

Background:Power Doppler ultrasound (PDUS) is superior to clinical examination in detecting synovitis in patients with rheumatoid arthritis (RA). Although dynamic and cheap it is impractical to scan large numbers of joints in routine clinical settings. MRI, whilst sensitive for synovitis, is expensive and routine use is limited to targeted joints. Bone scintigraphy produces whole body images but due to limited specificity is not routinely used.99mTc-maraciclatide (Serac Healthcare) is a radiolabelled tracer which binds with high affinity to integrin αvβ3, a cell-adhesion molecule up-regulated on neoangiogenic blood vessels. It therefore has the potential to image synovial inflammation at the whole-body level. We previously showed in a pilot study that uptake was seen in the inflamed joints of five RA patients and that this correlated with PDUS. This study explores correlation with PDUS in a larger groups of patients with varied disease activity.Objectives:To determine the correlation between ultrasound and99mTc-maraciclatide imaging in patients with rheumatoid arthritis.Methods:50 patients with RA fulfilling ACR 2010 classification criteria were recruited. Patients underwent an ultrasound scan of 40 joints with grey scale (GS) and PD quantification. Each joint was scored on a scale of 0-3 for GS and PD with a total score calculated for each patient. Within 3 hours of the ultrasound patients were injected with 740 MBq of99mTc-maraciclatide. Using a gamma camera, whole body planar views and dedicated hand and foot views were taken 2 hours after injection (Figure 1). Acquisition time was 20 minutes for whole body and 20 minutes for hand and foot views.99mTc-maraciclatide images were scored as positive or negative uptake for each joint (binary score). A quantitative score was also calculated for each joint where there was uptake with this corrected for background uptake. Total binary and quantitative scores per patient were calculated.Ultrasound and99mTc-maraciclatide scores were tested for correlation with Pearson’s correlation coefficient (r). Interrater agreement for 2 scorers was calculated using kappa (ĸ) and concordance correlation coefficient (Pc).Results:Strong correlation was seen when total PDUS was compared to binary scores (r=0.92, r2=0.85) (Figure 2) and quantitative scores (r=0.85, r2=0.72). ĸ was 0.82 and 0.79 for binary and ultrasound scores respectively.Pcwas 0.82 for quantitative scores. p was <0.0005 for all results.99mTc-maraciclatide uptake was also seen in inflamed tendons/tendon sheaths. The imaging procedure was well-tolerated. There were no tracer-related adverse events.Figure 1.99mTc-maraciclatide imaging with dedicated hand and foot viewsConclusion:99mTc-maraciclatide uptake was highly correlated with PDUS highlighting its potential as an alternative imaging modality.99mTc-based planar imaging has the unique capacity to image the whole body and hence the total synovial inflammatory load in a quick acquisition. The imaging equipment to perform these scans is already widely available in radiology departments. Interpretation of scans is also much simpler compared to US/MRI. It could therefore have a role in key decision-making points in pathways for diagnosis, treatment failure, and remission prior to dose tapering.Figure 2.Correlation between total power doppler and99mTc-maraciclatide binary scoresDisclosure of Interests:None declared

Teeth Impaction and Structural Teeth Anomalies

2020 ◽  
Vol 24 (05) ◽  
pp. 523-534
Author(s):  
Danisia Haba ◽  
Yllka Decolli ◽  
Emilia Marciuc ◽  
Ana Elena Sîrghe
Keyword(s):  
Root Resorption ◽  
Imaging Modality ◽  
Cleidocranial Dysplasia ◽  
Dental Anomalies ◽  
Marginal Bone Loss ◽  
Systematic Analysis ◽  
External Root Resorption ◽  
Adjacent Structures ◽  
Precise Diagnosis ◽  
Characteristic Features

AbstractDentists and oral and maxillofacial radiologists have used periapical, occlusal, panoramic, and cephalometric radiographs for many years for diagnosing dental anomalies, especially before orthodontic or surgical treatment. Cone beam computed tomography was developed in recent years especially for the dental and maxillofacial region. Thus it has become the imaging modality of choice for many clinical situations, such as the assessment of dental impaction and structural teeth anomalies or other associated diseases and disorders (e.g., Gardner's syndrome, cleidocranial dysplasia). This article reviews different aspects of dental impaction and its possible effects on adjacent structures such as external root resorption, marginal bone loss, as well as describing structural dental anomalies. It provides a systematic analysis of their characteristic features and imaging findings for general radiologists to achieve a precise diagnosis and an optimal interpretation.

scholarly journals Ultrasonographic Evaluation of the Shoulders and Its Associations with Shoulder Pain, Age, and Swim Training in Masters Swimmers

Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 29
Author(s):  
Yuta Suzuki ◽  
Noriaki Maeda ◽  
Junpei Sasadai ◽  
Kazuki Kaneda ◽  
Taizan Shirakawa ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Structural Changes ◽  
Partial Tear ◽  
Increased Risk ◽  
High Prevalence ◽  
History Of ◽  
Long Head ◽  
Competitive Swimmers ◽  
Rotator Cuff Tendinopathy

Background and objectives: The long head of the biceps (LHB) and rotator cuff tendinopathy is the major cause of shoulder pain in competitive swimmers. The risk of tendinopathy increases with aging; however, the structural changes of LHB and rotator cuff in populations of masters swimmers have not been well examined. The purpose of this study was to investigate the prevalence of ultrasonographic abnormalities of the shoulders in masters swimmers, and the association of pain, age, and swim training with structural changes in this population. Materials and Methods: A total of 60 subjects participated in this study, with 20 masters swimmers with shoulder pain, 20 asymptomatic masters swimmers, and 20 sex- and age-matched controls. All swimmers completed a self-reported questionnaire for shoulder pain, their history of competition, and training volume. Each subject underwent ultrasonographic examination of both shoulders for pathologic findings in the LHB tendon, rotator cuff (supraspinatus (SSP) and subscapularis (SSC)) tendons, and subacromial bursa (SAB) of both shoulders and had thickness measured. Results: The prevalence of tendinosis (LHB, 48.8%; SSP, 17.5%; SSC, 15.9%), partial tear (SSP, 35.0%), and calcification (SSC, 10.0%) were higher in swimmers than in controls. LHB and SSP tendinosis were associated with shoulder pain. Older age and later start of competition were associated with an increased risk of LHB tendinosis and SSC calcification. Earlier initiation of swimming and longer history of competition were associated with an increased risk of SSP and SSC tendinosis. The thicker SSP tendon significantly increased the risk of tendinosis and partial tear. Conclusions: A high prevalence of structural changes in the rotator cuff and biceps tendons in masters swimmers reflects the effect of shoulder symptoms, aging, and swim training.

scholarly journals Painful shoulder joint in rheumatoid arthritis.

1985 ◽  
Vol 34 (2) ◽  
pp. 592-594
Author(s):  
Akio Nakamura ◽  
Koji Kuroda ◽  
Minoru Ikeda ◽  
Naoto Takagishi
Keyword(s):  
Rheumatoid Arthritis ◽  
Shoulder Joint ◽  
Painful Shoulder

scholarly journals Ultrasound of Subtalar Joint Synovitis in Patients with Rheumatoid Arthritis: Results of an OMERACT Reliability Exercise Using Consensual Definitions

2018 ◽  
Vol 46 (4) ◽  
pp. 351-359 ◽  
Author(s):  
George A.W. Bruyn ◽  
Heidi J. Siddle ◽  
Petra Hanova ◽  
Félicie Costantino ◽  
Annamaria Iagnocco ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Subtalar Joint ◽  
Interobserver Reliability ◽  
Power Doppler ◽  
Delphi Process ◽  
Joint Effusion ◽  
Synovial Hypertrophy ◽  
Reliable Tool

Objective.To evaluate the intraobserver and interobserver reliability of the ultrasonographic (US) assessment of subtalar joint (STJ) synovitis in patients with rheumatoid arthritis (RA).Methods.Following a Delphi process, 12 sonographers conducted an US reliability exercise on 10 RA patients with hindfoot pain. The anteromedial, posteromedial, and posterolateral STJ was assessed using B-mode and power Doppler (PD) techniques according to an agreed US protocol and using a 4-grade semiquantitative grading score for synovitis [synovial hypertrophy (SH) and signal] and a dichotomous score for the presence of joint effusion (JE). Intraobserver and interobserver reliability were computed by Cohen’s and Light’s κ. Weighted κ coefficients with absolute weighting were computed for B-mode and PD signal.Results.Mean weighted Cohen’s κ for SH, PD, and JE were 0.80 (95% CI 0.62–0.98), 0.61 (95% CI 0.48–0.73), and 0.52 (95% CI 0.36–0.67), respectively. Weighted Cohen’s κ for SH, PD, and JE in the anteromedial, posteromedial, and posterolateral STJ were −0.04 to 0.79, 0.42–0.95, and 0.28–0.77; 0.31–1, −0.05 to 0.65, and −0.2 to 0.69; 0.66–1, 0.52–1, and 0.42–0.88, respectively. Weighted Light’s κ for SH was 0.67 (95% CI 0.58–0.74), 0.46 (95% CI 0.35–0.59) for PD, and 0.16 (95% CI 0.08–0.27) for JE. Weighted Light’s κ for SH, PD, and JE were 0.63 (95% CI 0.45–0.82), 0.33 (95% CI 0.19–0.42), and 0.09 (95% CI −0.01 to 0.19), for the anteromedial; 0.49 (95% CI 0.27–0.64), 0.35 (95% CI 0.27–0.4), and 0.04 (95% CI −0.06 to 0.1) for posteromedial; and 0.82 (95% CI 0.75–0.89), 0.66 (95% CI 0.56–0.8), and 0.18 (95% CI 0.04–0.34) for posterolateral STJ, respectively.Conclusion.Using a multisite assessment, US appears to be a reliable tool for assessing synovitis of STJ in RA.

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