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1. AB0187 ULTRASOUND FEATURES IN PATIENTS WITH INFLAMMATORY ARTHRITIS AND ARTHRALGIA FOLLOWING IMMUNE CHECKPOINT INHIBITOR THERAPY FOR CANCER: RESULTS OF A MULTI-CENTRE STUDY

Author

Harnden, K., primary, Di Matteo, A., additional, Di Geso, L., additional, Horvath, R., additional, Hurnakova, J., additional, Okano, T., additional, Sharrack, S., additional, Sahin Eroglu, D., additional, Emery, P., additional, Filippucci, E., additional, and Mankia, K., additional

Published
2024
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2. Reliability assessment of ultrasound muscle echogenicity in patients with rheumatic diseases: Results of a multicenter international web-based study

Author

Di Matteo, A, Moscioni, E, Lommano, M, Cipolletta, E, Smerilli, G, Farah, S, Airoldi, C, Aydin, S, Becciolini, A, Bonfiglioli, K, Carotti, M, Carrara, G, Cazenave, T, Corradini, D, Cosatti, M, de Agustin, J, Destro Castaniti, G, Di Carlo, M, Di Donato, E, Di Geso, L, Elliott, A, Fodor, D, Francioso, F, Gabba, A, Hernandez-Diaz, C, Horvath, R, Hurnakova, J, Jesus, D, Marin, J, Martire, M, Mashadi Mirza, R, Massarotti, M, Musca, A, Nair, J, Okano, T, Papalopoulos, I, Rosa, J, Rosemffet, M, Rovisco, J, Rozza, D, Salaffi, F, Scioscia, C, Scire, C, Tamas, M, Tanimura, S, Ventura-Rios, L, Villota-Eraso, C, Villota, O, Voulgari, P, Vreju, F, Vukatana, G, Hereter, J, Zanetti, A, Grassi, W, Filippucci, E, Di Matteo A., Moscioni E., Lommano M. G., Cipolletta E., Smerilli G., Farah S., Airoldi C., Aydin S. Z., Becciolini A., Bonfiglioli K., Carotti M., Carrara G., Cazenave T., Corradini D., Cosatti M. A., de Agustin J. J., Destro Castaniti G. M., Di Carlo M., Di Donato E., Di Geso L., Elliott A., Fodor D., Francioso F., Gabba A., Hernandez-Diaz C., Horvath R., Hurnakova J., Jesus D., Marin J., Martire M. V., Mashadi Mirza R., Massarotti M., Musca A. A., Nair J., Okano T., Papalopoulos I., Rosa J., Rosemffet M., Rovisco J., Rozza D., Salaffi F., Scioscia C., Scire C. A., Tamas M. -M., Tanimura S., Ventura-Rios L., Villota-Eraso C., Villota O., Voulgari P. V., Vreju F. A., Vukatana G., Hereter J. Z., Zanetti A., Grassi W., Filippucci E., Di Matteo, A, Moscioni, E, Lommano, M, Cipolletta, E, Smerilli, G, Farah, S, Airoldi, C, Aydin, S, Becciolini, A, Bonfiglioli, K, Carotti, M, Carrara, G, Cazenave, T, Corradini, D, Cosatti, M, de Agustin, J, Destro Castaniti, G, Di Carlo, M, Di Donato, E, Di Geso, L, Elliott, A, Fodor, D, Francioso, F, Gabba, A, Hernandez-Diaz, C, Horvath, R, Hurnakova, J, Jesus, D, Marin, J, Martire, M, Mashadi Mirza, R, Massarotti, M, Musca, A, Nair, J, Okano, T, Papalopoulos, I, Rosa, J, Rosemffet, M, Rovisco, J, Rozza, D, Salaffi, F, Scioscia, C, Scire, C, Tamas, M, Tanimura, S, Ventura-Rios, L, Villota-Eraso, C, Villota, O, Voulgari, P, Vreju, F, Vukatana, G, Hereter, J, Zanetti, A, Grassi, W, Filippucci, E, Di Matteo A., Moscioni E., Lommano M. G., Cipolletta E., Smerilli G., Farah S., Airoldi C., Aydin S. Z., Becciolini A., Bonfiglioli K., Carotti M., Carrara G., Cazenave T., Corradini D., Cosatti M. A., de Agustin J. J., Destro Castaniti G. M., Di Carlo M., Di Donato E., Di Geso L., Elliott A., Fodor D., Francioso F., Gabba A., Hernandez-Diaz C., Horvath R., Hurnakova J., Jesus D., Marin J., Martire M. V., Mashadi Mirza R., Massarotti M., Musca A. A., Nair J., Okano T., Papalopoulos I., Rosa J., Rosemffet M., Rovisco J., Rozza D., Salaffi F., Scioscia C., Scire C. A., Tamas M. -M., Tanimura S., Ventura-Rios L., Villota-Eraso C., Villota O., Voulgari P. V., Vreju F. A., Vukatana G., Hereter J. Z., Zanetti A., Grassi W., and Filippucci E.

Abstract

Objectives: To investigate the inter/intra-reliability of ultrasound (US) muscle echogenicity in patients with rheumatic diseases. Methods: Forty-two rheumatologists and 2 radiologists from 13 countries were asked to assess US muscle echogenicity of quadriceps muscle in 80 static images and 20 clips from 64 patients with different rheumatic diseases and 8 healthy subjects. Two visual scales were evaluated, a visual semi-quantitative scale (0–3) and a continuous quantitative measurement (“VAS echogenicity,” 0–100). The same assessment was repeated to calculate intra-observer reliability. US muscle echogenicity was also calculated by an independent research assistant using a software for the analysis of scientific images (ImageJ). Inter and intra reliabilities were assessed by means of prevalence-adjusted bias-adjusted Kappa (PABAK), intraclass correlation coefficient (ICC) and correlations through Kendall’s Tau and Pearson’s Rho coefficients. Results: The semi-quantitative scale showed a moderate inter-reliability [PABAK = 0.58 (0.57–0.59)] and a substantial intra-reliability [PABAK = 0.71 (0.68–0.73)]. The lowest inter and intra-reliability results were obtained for the intermediate grades (i.e., grade 1 and 2) of the semi-quantitative scale. “VAS echogenicity” showed a high reliability both in the inter-observer [ICC = 0.80 (0.75–0.85)] and intra-observer [ICC = 0.88 (0.88–0.89)] evaluations. A substantial association was found between the participants assessment of the semi-quantitative scale and “VAS echogenicity” [ICC = 0.52 (0.50–0.54)]. The correlation between these two visual scales and ImageJ analysis was high (tau = 0.76 and rho = 0.89, respectively). Conclusion: The results of this large, multicenter study highlighted the overall good inter and intra-reliability of the US assessment of muscle echogenicity in patients with different rheumatic diseases.

Published
2023

3. Reliability assessment of the definition of ultrasound enthesitis in SpA: results of a large, multicentre, international, web-based study

Author

Di Matteo, A, Cipolletta, E, Castaniti, G, Smerilli, G, Airoldi, C, Aydin, S, Becciolini, A, Bonfiglioli, K, Bruns, A, Carrara, G, Cazenave, T, Ciapetti, A, Cosatti, M, de Agustin, J, Di Carlo, M, Di Donato, E, Di Geso, L, Duran, E, Elliott, A, Estrach, C, Farisogullari, B, Fiorenza, A, Fodor, D, Gabba, A, Hernandez-Diaz, C, Huang, F, Hurnakova, J, Li, L, Jesus, D, Karadag, O, Martire, M, Massarotti, M, Michelena, X, Musca, A, Nair, J, Okano, T, Papalopoulos, I, Rosemffet, M, Rovisco, J, Rozza, D, Salaffi, F, Satulu, I, Scioscia, C, Scire, C, Sun, F, Tamas, M, Tanimura, S, Ventura-Rios, L, Voulgari, P, Vreju, F, Vukatana, G, Wong, E, Yang, J, Hereter, J, Zanetti, A, Grassi, W, Filippucci, E, Di Matteo A., Cipolletta E., Castaniti G. M. D., Smerilli G., Airoldi C., Aydin S. Z., Becciolini A., Bonfiglioli K., Bruns A., Carrara G., Cazenave T., Ciapetti A., Cosatti M. A., de Agustin J. J., Di Carlo M., Di Donato E., Di Geso L., Duran E., Elliott A., Estrach C., Farisogullari B., Fiorenza A., Fodor D., Gabba A., Hernandez-Diaz C., Huang F., Hurnakova J., Li L., Jesus D., Karadag O., Martire M. V., Massarotti M., Michelena X., Musca A. A., Nair J., Okano T., Papalopoulos I., Rosemffet M., Rovisco J., Rozza D., Salaffi F., Satulu I., Scioscia C., Scire C. A., Sun F., Tamas M. -M., Tanimura S., Ventura-Rios L., Voulgari P. V., Vreju F. A., Vukatana G., Wong E., Yang J., Hereter J. Z., Zanetti A., Grassi W., Filippucci E., Di Matteo, A, Cipolletta, E, Castaniti, G, Smerilli, G, Airoldi, C, Aydin, S, Becciolini, A, Bonfiglioli, K, Bruns, A, Carrara, G, Cazenave, T, Ciapetti, A, Cosatti, M, de Agustin, J, Di Carlo, M, Di Donato, E, Di Geso, L, Duran, E, Elliott, A, Estrach, C, Farisogullari, B, Fiorenza, A, Fodor, D, Gabba, A, Hernandez-Diaz, C, Huang, F, Hurnakova, J, Li, L, Jesus, D, Karadag, O, Martire, M, Massarotti, M, Michelena, X, Musca, A, Nair, J, Okano, T, Papalopoulos, I, Rosemffet, M, Rovisco, J, Rozza, D, Salaffi, F, Satulu, I, Scioscia, C, Scire, C, Sun, F, Tamas, M, Tanimura, S, Ventura-Rios, L, Voulgari, P, Vreju, F, Vukatana, G, Wong, E, Yang, J, Hereter, J, Zanetti, A, Grassi, W, Filippucci, E, Di Matteo A., Cipolletta E., Castaniti G. M. D., Smerilli G., Airoldi C., Aydin S. Z., Becciolini A., Bonfiglioli K., Bruns A., Carrara G., Cazenave T., Ciapetti A., Cosatti M. A., de Agustin J. J., Di Carlo M., Di Donato E., Di Geso L., Duran E., Elliott A., Estrach C., Farisogullari B., Fiorenza A., Fodor D., Gabba A., Hernandez-Diaz C., Huang F., Hurnakova J., Li L., Jesus D., Karadag O., Martire M. V., Massarotti M., Michelena X., Musca A. A., Nair J., Okano T., Papalopoulos I., Rosemffet M., Rovisco J., Rozza D., Salaffi F., Satulu I., Scioscia C., Scire C. A., Sun F., Tamas M. -M., Tanimura S., Ventura-Rios L., Voulgari P. V., Vreju F. A., Vukatana G., Wong E., Yang J., Hereter J. Z., Zanetti A., Grassi W., and Filippucci E.

Abstract

Objectives. To investigate the reliability of the OMERACT US Task Force definition of US enthesitis in SpA. Methods. In this web exercise, based on the evaluation of 101 images and 39 clips of the main entheses of the lower limbs, the elementary components included in the OMERACT definition of US enthesitis in SpA (hypoechoic areas, entheseal thickening, power Doppler signal at the enthesis, enthesophytes/calcifications, bone erosions) were assessed by 47 rheumatologists from 37 rheumatology centres in 15 countries. Inter- and intra-observer reliability of the US components of enthesitis was calculated using Light’s kappa, Cohen’s kappa, Prevalence And Bias Adjusted Kappa (PABAK) and their 95% CIs. Results. Bone erosions and power Doppler signal at the enthesis showed the highest overall inter-reliability [Light’s kappa: 0.77 (0.76–0.78), 0.72 (0.71–0.73), respectively; PABAK: 0.86 (0.86–0.87), 0.73 (0.73–0.74), respectively], followed by enthesophytes/calcifications [Light’s kappa: 0.65 (0.64–0.65), PABAK: 0.67 (0.67–0.68)]. This was moderate for entheseal thickening [Light’s kappa: 0.41 (0.41–0.42), PABAK: 0.41 (0.40–0.42)], and fair for hypoechoic areas [Light’s kappa: 0.37 (0.36–0.38); PABAK: 0.37 (0.37–0.38)]. A similar trend was observed in the intra-reliability exercise, although this was characterized by an overall higher degree of reliability for all US elementary components compared with the inter-observer evaluation. Conclusions. The results of this multicentre, international, web-based study show a good reliability of the OMERACT US definition of bone erosions, power Doppler signal at the enthesis and enthesophytes/calcifications. The low reliability of entheseal thickening and hypoechoic areas raises questions about the opportunity to revise the definition of these two major components for the US diagnosis of enthesitis.

Published
2022

6. Reliability assessment of the definition of ultrasound enthesitis in SpA: results of a large, multicentre, international, web-based study

Author

Andrea Di Matteo, Edoardo Cipolletta, Giulia Maria Destro Castaniti, Gianluca Smerilli, Carla Airoldi, Sibel Zehra Aydin, Andrea Becciolini, Karina Bonfiglioli, Alessandra Bruns, Greta Carrara, Tomas Cazenave, Alessandro Ciapetti, Micaela Ana Cosatti, Juan José de Agustín, Marco Di Carlo, Eleonora Di Donato, Luca Di Geso, Emine Duran, Ashley Elliott, Cristina Estrach, Bayram Farisogulları, Alessia Fiorenza, Daniela Fodor, Alessandra Gabba, Cristina Hernández-Díaz, Feng Huang, Jana Hurnakova, Ling Li, Diogo Jesus, Omer Karadag, Maria Victoria Martire, Marco Massarotti, Xabier Michelena, Alice Andreea Musca, Jagdish Nair, Tadashi Okano, Ioannis Papalopoulos, Marcos Rosemffet, João Rovisco, Davide Rozza, Fausto Salaffi, Iulia Satulu, Crescenzio Scioscia, Carlo Alberto Scirè, Fei Sun, Maria-Magdalena Tamas, Shun Tanimura, Lucio Ventura-Rios, Paraksevi V Voulgari, Florentin Ananu Vreju, Gentiana Vukatana, Ernest Wong, Jinshui Yang, Johana Zacariaz Hereter, Anna Zanetti, Walter Grassi, Emilio Filippucci, Di Matteo, A, Cipolletta, E, Castaniti, G, Smerilli, G, Airoldi, C, Aydin, S, Becciolini, A, Bonfiglioli, K, Bruns, A, Carrara, G, Cazenave, T, Ciapetti, A, Cosatti, M, de Agustin, J, Di Carlo, M, Di Donato, E, Di Geso, L, Duran, E, Elliott, A, Estrach, C, Farisogullari, B, Fiorenza, A, Fodor, D, Gabba, A, Hernandez-Diaz, C, Huang, F, Hurnakova, J, Li, L, Jesus, D, Karadag, O, Martire, M, Massarotti, M, Michelena, X, Musca, A, Nair, J, Okano, T, Papalopoulos, I, Rosemffet, M, Rovisco, J, Rozza, D, Salaffi, F, Satulu, I, Scioscia, C, Scire, C, Sun, F, Tamas, M, Tanimura, S, Ventura-Rios, L, Voulgari, P, Vreju, F, Vukatana, G, Wong, E, Yang, J, Hereter, J, Zanetti, A, Grassi, W, and Filippucci, E

Subjects
power Doppler signal, Internet, reliability, ultrasound, Reproducibility of Results, seronegative spondyloarthriti, Ultrasonography, Doppler, Enthesopathy, enthesiti, PsA, Rheumatology, Humans, Pharmacology (medical), multicenter international study, Ultrasonography
Abstract

Objectives To investigate the reliability of the OMERACT US Task Force definition of US enthesitis in SpA. Methods In this web exercise, based on the evaluation of 101 images and 39 clips of the main entheses of the lower limbs, the elementary components included in the OMERACT definition of US enthesitis in SpA (hypoechoic areas, entheseal thickening, power Doppler signal at the enthesis, enthesophytes/calcifications, bone erosions) were assessed by 47 rheumatologists from 37 rheumatology centres in 15 countries. Inter- and intra-observer reliability of the US components of enthesitis was calculated using Light’s kappa, Cohen’s kappa, Prevalence And Bias Adjusted Kappa (PABAK) and their 95% CIs. Results Bone erosions and power Doppler signal at the enthesis showed the highest overall inter-reliability [Light’s kappa: 0.77 (0.76–0.78), 0.72 (0.71–0.73), respectively; PABAK: 0.86 (0.86–0.87), 0.73 (0.73–0.74), respectively], followed by enthesophytes/calcifications [Light’s kappa: 0.65 (0.64–0.65), PABAK: 0.67 (0.67–0.68)]. This was moderate for entheseal thickening [Light’s kappa: 0.41 (0.41–0.42), PABAK: 0.41 (0.40–0.42)], and fair for hypoechoic areas [Light’s kappa: 0.37 (0.36–0.38); PABAK: 0.37 (0.37–0.38)]. A similar trend was observed in the intra-reliability exercise, although this was characterized by an overall higher degree of reliability for all US elementary components compared with the inter-observer evaluation. Conclusions The results of this multicentre, international, web-based study show a good reliability of the OMERACT US definition of bone erosions, power Doppler signal at the enthesis and enthesophytes/calcifications. The low reliability of entheseal thickening and hypoechoic areas raises questions about the opportunity to revise the definition of these two major components for the US diagnosis of enthesitis.

Published
2022
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7. Reliability assessment of ultrasound muscle echogenicity in patients with rheumatic diseases: Results of a multicenter international web-based study

Author

Andrea Di Matteo, Erica Moscioni, Maria Giovanna Lommano, Edoardo Cipolletta, Gianluca Smerilli, Sonia Farah, Carla Airoldi, Sibel Zehra Aydin, Andrea Becciolini, Karina Bonfiglioli, Marina Carotti, Greta Carrara, Tomas Cazenave, Davide Corradini, Micaela Ana Cosatti, Juan Josè de Agustin, Giulia Maria Destro Castaniti, Marco Di Carlo, Eleonora Di Donato, Luca Di Geso, Ashley Elliott, Daniela Fodor, Francesca Francioso, Alessandra Gabba, Cristina Hernández-Díaz, Rudolf Horvath, Jana Hurnakova, Diogo Jesus, Josefina Marin, Maria Victoria Martire, Riccardo Mashadi Mirza, Marco Massarotti, Alice Andreea Musca, Jagdish Nair, Tadashi Okano, Ioannis Papalopoulos, Javier Rosa, Marcos Rosemffet, João Rovisco, Davide Rozza, Fausto Salaffi, Crescenzio Scioscia, Carlo Alberto Scirè, Maria-Magdalena Tamas, Shun Tanimura, Lucio Ventura-Rios, Catalina Villota-Eraso, Orlando Villota, Paraskevi V. Voulgari, Florentin Ananu Vreju, Gentiana Vukatana, Johana Zacariaz Hereter, Anna Zanetti, Walter Grassi, Emilio Filippucci, Institut Català de la Salut, [Di Matteo A] Rheumatology Unit, Department of Clinical and Molecular Sciences, 'Carlo Urbani' Hospital, Polytechnic University of Marche, Ancona, Italy. Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom. [Moscioni E, Lommano MG, Cipolletta E, Smerilli G, Farah S] Rheumatology Unit, Department of Clinical and Molecular Sciences, 'Carlo Urbani' Hospital, Polytechnic University of Marche, Ancona, Italy. [de Agustin JJ] Servei de Reumatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus, Di Matteo, A, Moscioni, E, Lommano, M, Cipolletta, E, Smerilli, G, Farah, S, Airoldi, C, Aydin, S, Becciolini, A, Bonfiglioli, K, Carotti, M, Carrara, G, Cazenave, T, Corradini, D, Cosatti, M, de Agustin, J, Destro Castaniti, G, Di Carlo, M, Di Donato, E, Di Geso, L, Elliott, A, Fodor, D, Francioso, F, Gabba, A, Hernandez-Diaz, C, Horvath, R, Hurnakova, J, Jesus, D, Marin, J, Martire, M, Mashadi Mirza, R, Massarotti, M, Musca, A, Nair, J, Okano, T, Papalopoulos, I, Rosa, J, Rosemffet, M, Rovisco, J, Rozza, D, Salaffi, F, Scioscia, C, Scire, C, Tamas, M, Tanimura, S, Ventura-Rios, L, Villota-Eraso, C, Villota, O, Voulgari, P, Vreju, F, Vukatana, G, Hereter, J, Zanetti, A, Grassi, W, and Filippucci, E

Subjects
reliability, Otros calificadores::Otros calificadores::/diagnóstico por imagen [Otros calificadores], General Medicine, muscle echogenicity, sarcopenia, enfermedades musculoesqueléticas::enfermedades reumáticas [ENFERMEDADES], Músculs - Ecografia, Musculoskeletal Diseases::Rheumatic Diseases [DISEASES], rheumatic diseases, diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::ecografía [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Ultrasonography [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], musculoskeletal ultrasound, rheumatic disease, Reumatisme - Ecografia, Other subheadings::Other subheadings::/diagnostic imaging [Other subheadings]
Abstract

Muscle echogenicity; Musculoskeletal ultrasound; Rheumatic diseases Ecogenicidad muscular; Ecografía musculoesquelética; Enfermedades reumáticas Ecogenicitat muscular; Ecografia musculoesquelètica; Malalties reumàtiques Objectives: To investigate the inter/intra-reliability of ultrasound (US) muscle echogenicity in patients with rheumatic diseases. Methods: Forty-two rheumatologists and 2 radiologists from 13 countries were asked to assess US muscle echogenicity of quadriceps muscle in 80 static images and 20 clips from 64 patients with different rheumatic diseases and 8 healthy subjects. Two visual scales were evaluated, a visual semi-quantitative scale (0–3) and a continuous quantitative measurement (“VAS echogenicity,” 0–100). The same assessment was repeated to calculate intra-observer reliability. US muscle echogenicity was also calculated by an independent research assistant using a software for the analysis of scientific images (ImageJ). Inter and intra reliabilities were assessed by means of prevalence-adjusted bias-adjusted Kappa (PABAK), intraclass correlation coefficient (ICC) and correlations through Kendall’s Tau and Pearson’s Rho coefficients. Results: The semi-quantitative scale showed a moderate inter-reliability [PABAK = 0.58 (0.57–0.59)] and a substantial intra-reliability [PABAK = 0.71 (0.68–0.73)]. The lowest inter and intra-reliability results were obtained for the intermediate grades (i.e., grade 1 and 2) of the semi-quantitative scale. “VAS echogenicity” showed a high reliability both in the inter-observer [ICC = 0.80 (0.75–0.85)] and intra-observer [ICC = 0.88 (0.88–0.89)] evaluations. A substantial association was found between the participants assessment of the semi-quantitative scale and “VAS echogenicity” [ICC = 0.52 (0.50–0.54)]. The correlation between these two visual scales and ImageJ analysis was high (tau = 0.76 and rho = 0.89, respectively). Conclusion: The results of this large, multicenter study highlighted the overall good inter and intra-reliability of the US assessment of muscle echogenicity in patients with different rheumatic diseases. RH and JH were supported by Ministry of Health, Czech Republic – conceptual development of research organization, Motol University Hospital, Prague, Czech Republic (00064203).

Published
2023
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8. Power Doppler signal at the enthesis and bone erosions are the most discriminative OMERACT ultrasound lesions for SpA: results from the DEUS (Defining Enthesitis on Ultrasound in Spondyloarthritis) multicentre study.

Author

Di Matteo A, Smerilli G, Di Donato S, Liu AR, Becciolini A, Camarda F, Cazenave T, Cipolletta E, Corradini D, de Agustín JJ, Destro Castaniti GM, Di Donato E, Di Geso L, Duran E, Farisogullari B, Fornaro M, Francioso F, Giorgis P, Granel A, Hernández-Díaz C, Horvath R, Hurnakova J, Jesus D, Karadag O, Li L, Marin J, Martire MV, Michelena X, Moscioni E, Muntean L, Piga M, Rosemffet M, Rovisco J, Sahin D, Salaffi F, Saraiva L, Scioscia C, Tamas MM, Tanimura S, Venetsanopoulou A, Ventura-Rios L, Villota O, Villota-Eraso C, Voulgari PV, Vukatana G, Zacariaz Hereter J, Marzo-Ortega H, Grassi W, and Filippucci E

Subjects
Humans, Female, Male, Adult, Middle Aged, Arthritis, Psoriatic diagnostic imaging, Arthritis, Psoriatic complications, Severity of Illness Index, Achilles Tendon diagnostic imaging, Achilles Tendon pathology, Case-Control Studies, Enthesopathy diagnostic imaging, Ultrasonography, Doppler methods, Spondylarthritis diagnostic imaging, Spondylarthritis complications
Abstract

Objectives: To assess, in spondyloarthritis (SpA), the discriminative value of the Outcome Measures in Rheumatology (OMERACT) ultrasound lesions of enthesitis and their associations with clinical features in this population., Methods: In this multicentre study involving 20 rheumatology centres, clinical and ultrasound examinations of the lower limb large entheses were performed in 413 patients with SpA (axial SpA and psoriatic arthritis) and 282 disease controls (osteoarthritis and fibromyalgia). 'Active enthesitis' was defined as (1) power Doppler (PD) at the enthesis grade ≥1 plus entheseal thickening and/or hypoechoic areas, or (2) PD grade >1 (independent of the presence of entheseal thickening and/or hypoechoic areas)., Results: In the univariate analysis, all OMERACT lesions except enthesophytes/calcifications showed a significant association with SpA. PD (OR=8.77, 95% CI 4.40 to 19.20, p<0.001) and bone erosions (OR=4.75, 95% CI 2.43 to 10.10, p<0.001) retained this association in the multivariate analysis. Among the lower limb entheses, only the Achilles tendon was significantly associated with SpA (OR=1.93, 95% CI 1.30 to 2.88, p<0.001) in the multivariate analyses. Active enthesitis showed a significant association with SpA (OR=9.20, 95% CI 4.21 to 23.20, p<0.001), and unlike the individual OMERACT ultrasound lesions it was consistently associated with most clinical measures of SpA disease activity and severity in the regression analyses., Conclusions: This large multicentre study assessed the value of different ultrasound findings of enthesitis in SpA, identifying the most discriminative ultrasound lesions and entheseal sites for SpA. Ultrasound could differentiate between SpA-related enthesitis and other forms of entheseal pathology (ie, mechanical enthesitis), thus improving the assessment of entheseal involvement in SpA., Competing Interests: Competing interests: ADM has received speaking fees from Janssen and has received support for attending meetings by Galapagos outside the submitted work. GS has received speaking fees and support for attending meetings by Novartis outside the submitted work. EC has received speaking fees from Novartis outside the submitted work. EDD has received speaking fees from Novartis and has received support for attending meetings by AbbVie outside the submitted work. MF has received speaking fees from Galapagos, AbbVie, Boehringer Ingelheim, Lilly and GSK and has received support for attending meetings by Pfizer outside the submitted work. XM has received speaking fees from AbbVie, Lilly Novartis, UCB and Janssen and has received support for attending meetings by UCB and Janssen outside the submitted work. MGR has received speaking fees from AbbVie, Raffo and Tecnofarma outside the submitted work. HM-O has received research grants from Janssen, Novartis, Pfizer and UCB and honoraria/speaker fees from AbbVie, Amgen, Eli Lilly, Janssen, Moonlake, Novartis, Pfizer, Takeda and UCB non-relevant to the submitted work. WG has received speaking fees from Accademia di Medicina, Janssen, Angelini Ethos, Galapagos, Biopharma and UVET outside the submitted work. EF has received speaking fees from AbbVie, Amgen, BMS, Janssen, Lilly, Novartis, Pfizer and Union Chimique Belge Pharma outside the submitted work., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ on behalf of EULAR.)

Published
2024
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9. Reliability assessment of ultrasound muscle echogenicity in patients with rheumatic diseases: Results of a multicenter international web-based study.

Author

Di Matteo A, Moscioni E, Lommano MG, Cipolletta E, Smerilli G, Farah S, Airoldi C, Aydin SZ, Becciolini A, Bonfiglioli K, Carotti M, Carrara G, Cazenave T, Corradini D, Cosatti MA, de Agustin JJ, Destro Castaniti GM, Di Carlo M, Di Donato E, Di Geso L, Elliott A, Fodor D, Francioso F, Gabba A, Hernández-Díaz C, Horvath R, Hurnakova J, Jesus D, Marin J, Martire MV, Mashadi Mirza R, Massarotti M, Musca AA, Nair J, Okano T, Papalopoulos I, Rosa J, Rosemffet M, Rovisco J, Rozza D, Salaffi F, Scioscia C, Scirè CA, Tamas MM, Tanimura S, Ventura-Rios L, Villota-Eraso C, Villota O, Voulgari PV, Vreju FA, Vukatana G, Hereter JZ, Zanetti A, Grassi W, and Filippucci E

Abstract

Objectives: To investigate the inter/intra-reliability of ultrasound (US) muscle echogenicity in patients with rheumatic diseases., Methods: Forty-two rheumatologists and 2 radiologists from 13 countries were asked to assess US muscle echogenicity of quadriceps muscle in 80 static images and 20 clips from 64 patients with different rheumatic diseases and 8 healthy subjects. Two visual scales were evaluated, a visual semi-quantitative scale (0-3) and a continuous quantitative measurement ("VAS echogenicity," 0-100). The same assessment was repeated to calculate intra-observer reliability. US muscle echogenicity was also calculated by an independent research assistant using a software for the analysis of scientific images (ImageJ). Inter and intra reliabilities were assessed by means of prevalence-adjusted bias-adjusted Kappa (PABAK), intraclass correlation coefficient (ICC) and correlations through Kendall's Tau and Pearson's Rho coefficients., Results: The semi-quantitative scale showed a moderate inter-reliability [PABAK = 0.58 (0.57-0.59)] and a substantial intra-reliability [PABAK = 0.71 (0.68-0.73)]. The lowest inter and intra-reliability results were obtained for the intermediate grades (i.e., grade 1 and 2) of the semi-quantitative scale. "VAS echogenicity" showed a high reliability both in the inter-observer [ICC = 0.80 (0.75-0.85)] and intra-observer [ICC = 0.88 (0.88-0.89)] evaluations. A substantial association was found between the participants assessment of the semi-quantitative scale and "VAS echogenicity" [ICC = 0.52 (0.50-0.54)]. The correlation between these two visual scales and ImageJ analysis was high (tau = 0.76 and rho = 0.89, respectively)., Conclusion: The results of this large, multicenter study highlighted the overall good inter and intra-reliability of the US assessment of muscle echogenicity in patients with different rheumatic diseases., Competing Interests: SA received honoraria from AbbVie, Celgene, UCB, Novartis, Janssen, Pfizer, and Sanofi. AB served as a speaker for AbbVie, Amgen, Sanofi-Genzyme, and UCB, outside the submitted work. EF had received speaking fees from AbbVie, Amgen, BMS, Janssen, Lilly, Novartis, Roche, Pfizer, and UCB, outside the submitted work. WG had received speaking fees from Celltrion and Pfizer, outside the submitted work., (Copyright © 2023 Di Matteo, Moscioni, Lommano, Cipolletta, Smerilli, Farah, Airoldi, Aydin, Becciolini, Bonfiglioli, Carotti, Carrara, Cazenave, Corradini, Cosatti, de Agustin, Destro Castaniti, Di Carlo, Di Donato, Di Geso, Elliott, Fodor, Francioso, Gabba, Hernández-Díaz, Horvath, Hurnakova, Jesus, Marin, Martire, Mashadi Mirza, Massarotti, Musca, Nair, Okano, Papalopoulos, Rosa, Rosemffet, Rovisco, Rozza, Salaffi, Scioscia, Scirè, Tamas, Tanimura, Ventura-Rios, Villota-Eraso, Villota, Voulgari, Vreju, Vukatana, Hereter, Zanetti, Grassi and Filippucci.)

Published
2023
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10. Reliability assessment of the definition of ultrasound enthesitis in SpA: results of a large, multicentre, international, web-based study.

Author

Di Matteo A, Cipolletta E, Destro Castaniti GM, Smerilli G, Airoldi C, Aydin SZ, Becciolini A, Bonfiglioli K, Bruns A, Carrara G, Cazenave T, Ciapetti A, Cosatti MA, de Agustín JJ, Di Carlo M, Di Donato E, Di Geso L, Duran E, Elliott A, Estrach C, Farisogulları B, Fiorenza A, Fodor D, Gabba A, Hernández-Díaz C, Huang F, Hurnakova J, Li L, Jesus D, Karadag O, Martire MV, Massarotti M, Michelena X, Musca AA, Nair J, Okano T, Papalopoulos I, Rosemffet M, Rovisco J, Rozza D, Salaffi F, Satulu I, Scioscia C, Scirè CA, Sun F, Tamas MM, Tanimura S, Ventura-Rios L, Voulgari PV, Vreju FA, Vukatana G, Wong E, Yang J, Zacariaz Hereter J, Zanetti A, Grassi W, and Filippucci E

Subjects
Humans, Reproducibility of Results, Ultrasonography methods, Ultrasonography, Doppler methods, Internet, Enthesopathy diagnostic imaging
Abstract

Objectives: To investigate the reliability of the OMERACT US Task Force definition of US enthesitis in SpA., Methods: In this web exercise, based on the evaluation of 101 images and 39 clips of the main entheses of the lower limbs, the elementary components included in the OMERACT definition of US enthesitis in SpA (hypoechoic areas, entheseal thickening, power Doppler signal at the enthesis, enthesophytes/calcifications, bone erosions) were assessed by 47 rheumatologists from 37 rheumatology centres in 15 countries. Inter- and intra-observer reliability of the US components of enthesitis was calculated using Light's kappa, Cohen's kappa, Prevalence And Bias Adjusted Kappa (PABAK) and their 95% CIs., Results: Bone erosions and power Doppler signal at the enthesis showed the highest overall inter-reliability [Light's kappa: 0.77 (0.76-0.78), 0.72 (0.71-0.73), respectively; PABAK: 0.86 (0.86-0.87), 0.73 (0.73-0.74), respectively], followed by enthesophytes/calcifications [Light's kappa: 0.65 (0.64-0.65), PABAK: 0.67 (0.67-0.68)]. This was moderate for entheseal thickening [Light's kappa: 0.41 (0.41-0.42), PABAK: 0.41 (0.40-0.42)], and fair for hypoechoic areas [Light's kappa: 0.37 (0.36-0.38); PABAK: 0.37 (0.37-0.38)]. A similar trend was observed in the intra-reliability exercise, although this was characterized by an overall higher degree of reliability for all US elementary components compared with the inter-observer evaluation., Conclusions: The results of this multicentre, international, web-based study show a good reliability of the OMERACT US definition of bone erosions, power Doppler signal at the enthesis and enthesophytes/calcifications. The low reliability of entheseal thickening and hypoechoic areas raises questions about the opportunity to revise the definition of these two major components for the US diagnosis of enthesitis., (© The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Published
2022
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11. Isolated Pulmonic Valve Endocarditis.

Author

Parato VM, Di Geso L, Pelliccioni S, Parato AG, and Di Eusanio M

Abstract

Isolated pulmonic valve infective endocarditis (PV-IE) is a rare form of endocarditis. The authors report a case of giant vegetations detected by transthoracic echocardiography (TTE) on PV in a young patient, 33-year-old, with drug abuse history. The patient underwent surgical intervention by pulmonary valved bioconduit implantation. After operation, a pulmonary embolism episode was treated by a direct oral anticoagulant. The final outcome was favorable. The difficulty in diagnosing PV-IE is due to the inability to properly visualize the PV by echocardiography. In this case, with such large vegetations, TTE allowed a correct diagnosis and an effective surgical planning, confirming its importance as a diagnostic tool., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Cardiovascular Echography.)

Published
2022
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12. A Histologically Positive Giant Cell Arteritis After a 6-Week Glucocorticoid Treatment: A Case Report.

Author

Di Geso L, Rasetti C, Pellegrini D, Collina G, D'Angelo A, Corradini D, De Benedictis MG, Gismondi M, Lattanzi E, Scarpellini E, and Santori P

Subjects
Glucocorticoids, Humans, Giant Cell Arteritis diagnosis, Giant Cell Arteritis drug therapy, Giant Cell Arteritis pathology
Abstract

Competing Interests: The authors declare no conflict of interest.

Published
2021
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