Interobserver Reliability of Neovascularization Score Using Power Doppler Ultrasonography in Midportion Achilles Tendinopathy

2009 ◽  
Vol 37 (8) ◽  
pp. 1627-1631 ◽  
Author(s):  
Pieter M. Sengkerij ◽  
Robert-Jan de Vos ◽  
Adam Weir ◽  
Bert J. G. van Weelde ◽  
Johannes L. Tol
Keyword(s):  
Correlation Coefficient ◽  
Doppler Ultrasonography ◽  
Interobserver Reliability ◽  
Intraclass Correlation ◽  
Power Doppler ◽  
Achilles Tendinopathy ◽  
Power Doppler Ultrasonography ◽  
Level Of Evidence ◽  
The Difference ◽  
Control Study

Background Power Doppler ultrasonography is widely used to examine neovascularization in midportion Achilles tendinopathy. The reliability of the grading of the degree of neovascularization has not been examined previously. Hypothesis Power Doppler ultrasonography can be performed with a high interobserver reliability to determine the neovascularization score in patients with midportion Achilles tendinopathy. Study Design Case control study (diagnosis); Level of evidence, 4. Methods Thirty-three symptomatic and 17 asymptomatic Achilles tendons from 25 consecutive patients were included for ultrasound examination. Victorian Institute of Sport Assessment–Achilles score was used to assess the severity of the Achilles tendinopathy. Each tendon was scored twice by different radiologists using the modified Öhberg score for neovascularization. Results The intraclass correlation coefficient for interobserver reliability was 0.85. Neovascularization was observed in 70% (23/33) of the symptomatic tendons and in 29% (5/17) of the asymptomatic tendons. The Spearman correlation coefficient between the Victorian Institute of Sport Assessment–Achilles score and the degree of neovascularization was −0.16 (P =. 10). Conclusion An excellent interobserver reliability was found for determining the degree of neovascularization on power Doppler ultrasonography examination. Neovessels were present in a majority of symptomatic tendons. The severity of symptoms was not correlated with the neovascularization score. Clinical Relevance Power Doppler ultrasonography is widely used to evaluate tendinopathy without knowledge of the difference in observations between several testers. Interobserver reliability of the evaluation of the degree of neovascularization in chronic midportion Achilles tendinopathy is excellent.

The Value of Power Doppler Ultrasonography in Achilles Tendinopathy

2007 ◽  
Vol 35 (10) ◽  
pp. 1696-1701 ◽  
Author(s):  
Robert-Jan de Vos ◽  
Adam Weir ◽  
Lodewijk P. J. Cobben ◽  
Johannes L. Tol
Keyword(s):  
Conservative Treatment ◽  
Doppler Ultrasonography ◽  
Power Doppler ◽  
Achilles Tendinopathy ◽  
Clinical Severity ◽  
Power Doppler Ultrasonography ◽  
Level Of Evidence ◽  
Vas Score ◽  
The Mean

Background Neovascularization, detected with power Doppler ultrasonography (PDU), is thought by some to play a central role in pathogenesis of Achilles tendinopathy. Hypothesis Power Doppler ultrasonography neovascularization score is correlated with clinical severity at baseline and after conservative treatment. Study Design Cohort study (prognosis); Level of evidence, 2. Methods Seventy tendons from 58 patients with chronic midportion Achilles tendinopathy were included, and 63 symptomatic tendons were analyzed. All patients were prescribed a 12-week heavy-load eccentric training program and evaluated with PDU at baseline and 12 weeks. Patient satisfaction, Victorian Institute of Sports Assessment—Achilles (VISA-A) score, and mean visual analog scale (VAS) score were correlated with degree of neovascularization (5-grade scale). Results Of the 63 symptomatic tendons, baseline neovascularization scores were 23 grade 0 (37% no neovessels), 18 grade 1, 8 grade 2, 8 grade 3, and 6 grade 4 (63% neovascularization grades 1-4). At baseline, neovascularization was not significantly correlated with the mean VAS score (r = .19, P = .131) and VISA-A score (r = —.23, P = .074). At 12-week follow-up, the neovascularization score significantly correlated with the mean VAS score (r = .43, P < .001) and VISA-A score (r = —.46, P < .001). No significant differences were found in improvement of VISA-A score after treatment between patients with neovessels (grades 1-4) or without neovessels (grade 0) at baseline. Conclusion Sixty-three percent of the symptomatic tendons were found to have neovessels at baseline. There was no significant correlation between neovascularization score and clinical severity at baseline, but at follow-up, there was a significant correlation. Neovascularization at baseline did not predict clinical outcome after conservative treatment.

scholarly journals The PBS Score – a clinical assessment tool for the ambulatory and recurrent clubfoot

2019 ◽  
Vol 13 (3) ◽  
pp. 282-292 ◽  
Author(s):  
S. Böhm ◽  
M. F. Sinclair
Keyword(s):  
Correlation Coefficient ◽  
Clinical Assessment ◽  
Assessment Tool ◽  
Interobserver Reliability ◽  
Intraclass Correlation ◽  
Rank Correlation ◽  
Diagnostic Study ◽  
Level Of Evidence ◽  
Spearman’S Rank Correlation ◽  
Spearman’S Rank Correlation Coefficient

Purpose The signs for clubfoot relapse are poorly defined in the literature and there is a lack of a scoring system that allows assessment of clubfeet in ambulatory children. The aim of this study is to develop an easy to use, reliable and validated evaluation tool for ambulatory children with a history of clubfoot. Methods A total of 52 feet (26 children, 41 clubfeet, 11 unaffected feet) were assessed. Three surgeons used the seven-item PBS Score to rate hindfoot varus, standing and walking supination, early heel rise, active/passive ankle dorsiflexion and subtalar abduction blinded to the other examiners. All parents answered the modified Roye score questionnaire prior to the clinical assessment. Correlation between the mean PBS Score and the Roye score was evaluated using Spearman’s rank correlation coefficient. Interobserver reliability was tested using weighted and unweighted Cohen’s Kappa coefficients. Results The Spearman’s rank correlation coefficient for correlation between mean PBS Score and Roye score was 0.73 (moderate to good correlation).The interobserver agreement for the total PBS Score resulted in an intraclass correlation coefficient of 0.93 (almost perfect agreement). Conclusion The PBS score is an easy to use, clinical assessment tool for walking age children with clubfoot deformity. It includes passive and active criteria with a very good interobserver reliability and moderate to good validity. Level of Evidence: Level I - Diagnostic study

scholarly journals The Use of Doppler Ultrasound to Assess the Blood Flow of Pedicled Vascularized Bone Grafting for Scaphoid Nonunions

2020 ◽  
Vol 09 (05) ◽  
pp. 396-403 ◽  
Author(s):  
J. Terrence Jose Jerome ◽  
Ilayaraja Venkatachalam
Keyword(s):  
Blood Flow ◽  
High Frequency ◽  
Doppler Ultrasonography ◽  
Power Doppler ◽  
Bone Grafts ◽  
Power Doppler Ultrasonography ◽  
High Frequency Power ◽  
Level Of Evidence ◽  
Frequency Power ◽  
Vascularized Bone

Abstract Objectives This study aims to assess the blood flow and the vascularity pattern across the newly bridged vascularized bone grafts for scaphoid nonunions using three-dimensional (3D) high frequency power Doppler ultrasonography and its role in the union. Materials and Methods A total of 26 patients with scaphoid nonunions were operated with 1,2-intercompartmental supraretinacular artery (ICSRA) graft. CT scan and 3D high frequency power Doppler ultrasonography were performed in all patients between 12 and 18 weeks, and its results were analyzed. Results Doppler ultrasonography confirmed the pulsatile flow and vascularity across the pedicle and vascularized bone graft incorporation into the scaphoid nonunion site. Conclusions 3D high frequency power Doppler ultrasonography is a simple, noninvasive, nonradiation, reproducible, and well-reliable diagnostic modality in assessing the blood flow and vascularity of the bone grafts used for scaphoid nonunions. Level of Evidence This is a Level IV study.

scholarly journals Assessment of reliability and validity of the 5-scale grading system of the point-of-care immunoassay for tear matrix metalloproteinase-9

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Minjeong Kim ◽  
Ja Young Oh ◽  
Seon Ha Bae ◽  
Seung Hyeun Lee ◽  
Won Jun Lee ◽  
...  
Keyword(s):  
Matrix Metalloproteinase ◽  
Calibration Curve ◽  
Point Of Care ◽  
Interobserver Reliability ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Grading System ◽  
Intraclass Correlation Coefficients ◽  
The Difference

AbstractWe evaluated the reliability and validity of the 5-scale grading system to interpret the point-of-care immunoassay for tear matrix metalloproteinase (MMP)-9. Six observers graded red bands of photographs of the readout window in MMP-9 immunoassay kit (InflammaDry) two times with 2-week interval based on the 5-scale grading system (i.e. grade 0–4). Interobserver and intraobserver reliability were evaluated using intraclass correlation coefficients. The interobserver agreements were analyzed according to the severity of tear MMP-9 expression. To validate the system, a concentration calibration curve was made using MMP-9 solutions with reference concentrations, then the distribution of MMP-9 concentrations was analyzed according to the 5-scale grading system. Both intraobserver and interobserver reliability was excellent. The readout grades were significantly correlated with the quantified colorimetric densities. The interobserver variance of readout grades had no correlation with the severity of the measured densities. The band density continued to increase up to a maximal concentration (i.e. 5000 ng/mL) according to the calibration curve. The difference of grades reflected the change of MMP-9 concentrations sensitively, especially between grade 2 and 4. Together, our data indicate that the subjective 5-scale grading system in the point-of-care MMP-9 immunoassay is an easy and reliable method with acceptable accuracy.

scholarly journals AB0450 PERIPHERAL MACROVASCULAR INVOLVEMENT IN SYSTEMIC SCLEROSIS AS COMPARED WITH HEALTHY CONTROLS: A SMALL COHORT STUDY BY COLOR AND SPECTRAL DOPPLER ULTRASONOGRAPHY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1252.2-1252
Author(s):  
R. D’alessandro ◽  
E. Garcia Gonzales ◽  
P. Falsetti ◽  
C. Baldi ◽  
F. Bellisai ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Clinical Features ◽  
Doppler Ultrasonography ◽  
Power Doppler ◽  
Ulnar Artery ◽  
Artery Occlusion ◽  
Power Doppler Ultrasonography ◽  
Digital Ulcers ◽  
Healthy Controls ◽  
History Of

Background:Together with autoimmune-inflammation and fibrosis, microvasculopathy is a hallmark of SSc. However, also macrovascular changes may occur including peripheral proliferative vasculopathy. Whether this changes may represent a specific SSc marker with a predictive value remains a matter of debate.[1,2,3]Objectives:To study peripheral macrovascular involvement by color doppler ultrasound (CDUS) with spectral wave analysis (SWA) in a cohort of 40 SSc patients as compared to healthy controls. To further analyze any differences among the SSc population.Methods:Forty SSc patients and 36 healthy controls were examined by CDUS with SWA of both hands. Macrovascular involvement was assessed by measuring the resistivity index (RI) of distal ulnar and radial arteries. Examinations were performed with an Esaote MyLab Twice machine equipped with a linear 10-22 MHz probe. Ultrasound examination was carried out by two independent rheumatologists blinded to clinical conditions of the patients. Statistical analysis was performed by using MaxStat software.Results:The RI index resulted increased in the SSc cohort as compared with healthy controls (left ulnar RI 0.977 vs 0.715; right ulnar RI 0.996 vs 0.699; left radial RI 0.988 vs 0.706; right radial RI 0.999 vs 0.688; p<0.001). SSc patients with an increased RI in one artery were more probable to have an increased RI in the other vessels too (r 2 = 0.35; p<0.01). In addition, 8 out of 40 SSc patients presented left ulnar artery occlusion (UAO) and 7 out of 40 SSc patients presented right UAO, of which 6 presented bilateral UAO. Awaiting to enlarge the cohort for further analysis, descriptive data regarding increased RI at CDUS/SWA and clinical features, including years from onset of the disease, subtype of SSc, mRSS, history of digital ulcers, interstitial lung disease and PAH are described in Table 1.Conclusion:Peripheral macrovascular involvement was observed in SSc patients as compared with healthy controls. Further studies will determine whether this feature may have specificity for diagnosis/prognosis in SSc.References:[1]Lescoat A, Yelnik CM, Coiffier G et al. Ulnar Artery Occlusion and Severity Markers of Vasculopathy in Systemic Sclerosis: A Multicenter Cross-Sectional Study. Arthritis Rheumatol. 2019;71:983-990.[2]Lescoat A, Coiffier G, Rouil A et al. Vascular Evaluation of the Hand by Power Doppler Ultrasonography and New Predictive Markers of Ischemic Digital Ulcers in Systemic Sclerosis: Results of a Prospective Pilot Study. Arthritis Care Res (Hoboken). 2017;69:543-551.[3]Schioppo T, Orenti A, Boracchi P, De Lucia O, Murgo A, Ingegnoli F. Evidence of macro- and micro-angiopathy in scleroderma: An integrated approach combining 22-MHz power Doppler ultrasonography and video-capillaroscopy. Microvasc Res. 2019;122:125-130.Table 1.Main clinical features of the SSc cohort (n=40) studied by CDUS for macrovascular involvement.SSc cohort (n = 40)Years from onsetrange (35 y – 0 y)mean = 10.5 yAutoantibodiesACA 13/40Anti-TopoI 14/40Other 13/40mRSSrange (0 -30)mean = 3ILD17/40PAH7/40Capillaroscopy patternEarly 10/40Active 11/40Late 6/40History of digital ulcers16/40Left ulnar IR0.977Left radial IR0.988Right ulnar IR0.996Right radial IR0.999Disclosure of Interests:None declared.

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