1. A semiquantitative color Doppler ultrasound scoring system for evaluation of synovitis in joints of patients with blood-induced arthropathy
- Author
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Ningning Zhang, Sheng Yang, Anne-Fleur Zwagemaker, Aihua Huo, Ying-Jia Li, Fang Zhou, Pamela Hilliard, Sandra Squire, Vanessa Bouskill, Arun Mohanta, Alex Zhou, Jose Jarrin, Runhui Wu, Jing Sun, Brian Luke, Rahim Moineddin, Victor S. Blanchette, Yun Peng, and Andrea S. Doria
- Subjects
Color Doppler ultrasound ,Synovial hypertrophy ,Magnetic resonance imaging (MRI) ,Hemophilic arthropathy ,Children and adolescents. ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Abstract Background Intra-articular bleeds in patients with inherited bleeding disorders lead to active synovitis which may progress to a chronic state over time. We explored the diagnostic value of color Doppler ultrasound in detecting synovitis in boys with bleeding disorders. Results Sixty boys with hemophilia and 3 boys with type 3 von Willebrand disease aged 5 to 18 years (median 12.3 years) were imaged by gray-scale and color Doppler ultrasound (US) in three centers (Beijing, China [n = 22], Guangzhou, China [n = 12] and Toronto, Canada [n = 29])) in this observational study. Images were independently reviewed by two radiologists blinded to clinical data using a subjective semi-quantitative scoring system and objective measurements of synovial thickness and vascularity. Inter-reader reliability for using subjective versus objective color Doppler US methods for assessing synovial vascularity was excellent for the subjective method and moderate/lower range of substantial for the objective method. Agreement between degree of vascularity on color Doppler and extent of synovial hypertrophy on gray-scale US was overall poor for Canada data and moderate for China data. Correlations between degree of vascularity on color Doppler and synovial hypertrophy on gray-scale US, and clinical constructs (total and itemized HJHS scores and total Pettersson X-ray scores) for assessment of blood-induced arthropathy were all poor. Conclusion Color Doppler US is a valuable scoring method for evaluating reactive synovitis in joints of subjects with inherited bleeding disorders and holds potential for assessing post-bleed reactive synovitis once further information on its association with timing of the joint bleed becomes available in the literature.
- Published
- 2021
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