系统性硬化症患者手部和腕部滑膜炎及腱鞘炎超声检查结果的验证
Validation of Sonography findings of synovitis and tenosynovitis of hands and wrists in patients with systemic sclerosis.
作者信息
Scheiman-Elazary Anat, Ranganath Veena K, Ben-Artzi Ami, Kafaja Suzanne, Borazan Nabeel H, Woodworth Thasia, Duan Lewei, Elashoff David, Clements Philip, Furst Daniel E
机构信息
Rheumatology Unit, Division of Medicine, Hadassah Medical Center, Jerusalem, Israel.
Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
出版信息
J Scleroderma Relat Disord. 2018 Oct;3(3):228-236. doi: 10.1177/2397198318774301. Epub 2018 Jun 6.
OBJECTIVES
Validating musculoskeletal ultrasound features of the joints and tendons of the hands in a large scleroderma cohort.
METHODS
A total of 81 scleroderma patients participated in this prospective, cross-sectional study. Grayscale and power Doppler musculoskeletal ultrasound images of 13 joints and 5 tendons of the wrist and hand were obtained. Clinical assessment included modified Rodnan skin thickness score, joint count, and Scleroderma Health Assessment Questionnaire. Face validity, content validity, construct validity, and feasibility were assessed.
RESULTS
Mean age was 53.8 years (range 22-80), 76.5% were females, and disease duration ranged from 0.25 to 29 years. Mean length of the examination was 36 min. Scleroderma Health Assessment Questionnaire-Disability Index correlated with musculoskeletal ultrasound erosions (r = 0.5, p = 0.0003). Skin score correlated with tendinitis grayscale (r = 0.26, p = 0.02). Intra-reader correlation coefficient for musculoskeletal ultrasound was 0.96 for the joints and could not be calculated for tendons because there were too few positive findings. When tendon changes existed, percent of agreement was 77.7%-83.3%.
CONCLUSION
Musculoskeletal ultrasound of 13 joints and 5 tendons of the hands and wrist has face and content validity. Construct validity was shown for the tendons and erosion scores. Feasibility and reliability were partially validated.
目的
在一个大型硬皮病队列中验证手部关节和肌腱的肌肉骨骼超声特征。
方法
共有81例硬皮病患者参与了这项前瞻性横断面研究。获取了手腕和手部13个关节及5条肌腱的灰阶和能量多普勒肌肉骨骼超声图像。临床评估包括改良Rodnan皮肤厚度评分、关节计数和硬皮病健康评估问卷。评估了表面效度、内容效度、结构效度和可行性。
结果
平均年龄为53.8岁（范围22 - 80岁），76.5%为女性，病程为0.25至29年。平均检查时长为36分钟。硬皮病健康评估问卷 - 残疾指数与肌肉骨骼超声侵蚀相关（r = 0.5，p = 0.0003）。皮肤评分与肌腱炎灰阶相关（r = 0.26，p = 0.02）。肌肉骨骼超声的阅片者内相关系数对于关节为0.96，对于肌腱因阳性发现过少无法计算。当存在肌腱改变时，一致性百分比为77.7% - 83.3%。
结论
手部和手腕13个关节及5条肌腱的肌肉骨骼超声具有表面效度和内容效度。肌腱和侵蚀评分显示出结构效度。可行性和可靠性得到了部分验证。
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