Auckland University of Technology, Auckland, New Zealand.
University of Southampton, Southampton, United Kingdom.
Arthritis Care Res (Hoboken). 2024 Nov;76(11):1501-1510. doi: 10.1002/acr.25407. Epub 2024 Aug 10.
Ultrasound (US) imaging may play a fundamental role in the earlier detection and assessment of first metatarsophalangeal joint (MTPJ) osteoarthritis (OA) because of its ability to depict tissue-specific morphologic changes before the point of irreversible structural damage. However, the role of US in supporting the diagnosis of OA in foot joints has not been clearly defined. The aims of this study were to develop a semiquantitative US atlas (the AUT ultrasound imaging [AUTUSI] atlas) to grade the degree of osteoarthritic change in the first MTPJ and to evaluate the intraexaminer and interexaminer reproducibility of using the atlas.
US images were obtained from 57 participants (30 participants with radiographically confirmed first MTPJ OA). The AUTUSI atlas supports the examination of grading joint effusion, synovial hypertrophy, synovitis, osteophytes, joint space narrowing, and cartilage thickness. Six examiners used the atlas to independently grade 24 US images across 2 sessions. Intraexaminer and interexaminer reproducibility were determined using percentage agreement and Gwet's AC2.
Observations using the AUTUSI atlas demonstrated almost perfect-to-perfect interexaminer agreement (percentage agreement ranged from 96% to 100%, and Gwet's AC2 values ranged from 0.81 to 1.00) and moderate-to-perfect intraexaminer agreement (percentage agreement ranged from 67% to 100%, and Gwet's AC2 values ranged from 0.54 to 1.00).
The AUTUSI atlas demonstrated excellent intraexaminer and interexaminer reproducibility for evaluating first MTPJ joint effusion, synovial hypertrophy, synovitis, joint space narrowing, osteophytes, and cartilage thickness. The AUTUSI atlas affords an opportunity to detect prognostic markers of OA earlier in the disease cascade and has the potential to advance understanding of the pathologic process of first MTPJ OA.
超声（US）成像因其能够在不可逆结构损伤之前描绘组织特异性形态变化，因此可能在早期检测和评估第一跖趾关节（MTPJ）骨关节炎（OA）方面发挥重要作用。然而，US 在支持足部关节 OA 诊断中的作用尚未明确界定。本研究旨在制定半定量 US 图谱（AUT 超声成像[AUTUSI]图谱），以分级第一 MTPJ 骨关节炎的病变程度，并评估使用该图谱的观察者内和观察者间可重复性。
从 57 名参与者（30 名参与者的第一跖趾关节 OA 经放射学证实）中获得 US 图像。AUTUSI 图谱支持对关节积液、滑膜肥厚、滑膜炎、骨赘、关节间隙变窄和软骨厚度进行分级。6 名观察者在 2 个时段内使用图谱独立分级 24 个 US 图像。使用百分比一致性和 Gwet 的 AC2 来确定观察者内和观察者间的可重复性。
使用 AUTUSI 图谱进行的观察结果显示，观察者间几乎达到完美到完美的一致性（百分比一致性范围为 96%至 100%，Gwet 的 AC2 值范围为 0.81 至 1.00），观察者内一致性为中度到完美（百分比一致性范围为 67%至 100%，Gwet 的 AC2 值范围为 0.54 至 1.00）。
AUTUSI 图谱在评估第一 MTPJ 关节积液、滑膜肥厚、滑膜炎、关节间隙变窄、骨赘和软骨厚度方面表现出极好的观察者内和观察者间可重复性。AUTUSI 图谱为更早地检测 OA 的预后标志物提供了机会，并有可能深入了解第一 MTPJ OA 的病理过程。
