Università Politecnica delle Marche, Jesi, Ancona, Italy.
Arthritis Care Res (Hoboken). 2014 Jan;66(1):69-73. doi: 10.1002/acr.22190.
To determine the sensitivity, specificity, and accuracy of ultrasound (US) in the detection of cartilage calcification at knee level in patients with calcium pyrophosphate deposition disease (CPDD) and to assess the interobserver reliability.
Seventy-four CPDD patients and 83 controls with other chronic arthritis were included. All patients underwent a clinical examination, synovial fluid analysis, and radiographic assessment of the knee. US examinations were performed in order to detect hyperechoic spots within the hyaline cartilage layer and hyperechoic areas within the meniscal fibrocartilage. Twenty patients were assessed by 2 operators in order to calculate the interobserver reliability.
A total of 314 knees in 157 patients (74 with CPDD, 19 with rheumatoid arthritis, 17 with spondyloarthritis, 32 with osteoarthritis, and 15 with gout) were assessed. In the 74 patients with CPDD, hyaline cartilage spots were detected by US in at least 1 knee in 44 patients (59.5%), whereas radiography detected hyaline cartilage spots in 34 patients (45.9%) (P < 0.001). Meniscal fibrocartilage calcifications were detected by US in 67 of the 74 CPDD patients (90.5%), whereas conventional radiography detected calcifications in 62 patients (83.7%) (P = 0.011). The criterion validity expressed as percentage of sensitivity, specificity, and accuracy of US in the detection of articular cartilage calcification was high. Both kappa values and overall agreement percentages showed moderate to excellent agreement.
US is an accurate and reliable imaging technique in the detection of articular cartilage calcification at knee level in patients with CPDD.
确定超声（US）在检测焦磷酸钙沉积病（CPDD）患者膝关节软骨钙化中的敏感性、特异性和准确性，并评估其观察者间可靠性。
纳入 74 例 CPDD 患者和 83 例其他慢性关节炎对照者。所有患者均接受临床检查、关节液分析和膝关节影像学评估。行 US 检查以检测透明软骨层内的高回声点和半月板纤维软骨内的高回声区。为了计算观察者间的可靠性，对 20 例患者由 2 位操作者进行评估。
共评估了 157 例患者的 314 个膝关节（74 例 CPDD、19 例类风湿关节炎、17 例脊柱关节炎、32 例骨关节炎和 15 例痛风）。在 74 例 CPDD 患者中，44 例（59.5%）至少有 1 个膝关节的 US 检测到透明软骨斑点，而放射摄影仅在 34 例（45.9%）患者中检测到（P<0.001）。US 在 67 例 CPDD 患者中检测到半月板纤维软骨钙化，而常规放射摄影在 62 例患者中检测到钙化（P=0.011）。以敏感性、特异性和准确性的百分比表示的标准效度表明 US 检测关节软骨钙化的结果具有较高的准确性。kappa 值和总一致性百分比均显示出中等到极好的一致性。
US 是一种准确可靠的影像学技术，可用于检测 CPDD 患者膝关节软骨钙化。
