Cross-sectional reliability and concurrent validity of a quantitative 2-dimensional ultrasound image analysis of effusion and synovial hypertrophy in knee osteoarthritisKey messages

Robert Dima; Trevor B. Birmingham; Holly T. Philpott; Dianne Bryant; Aaron Fenster; C. Thomas Appleton

Osteoarthritis and Cartilage Open (Jun 2023)

Cross-sectional reliability and concurrent validity of a quantitative 2-dimensional ultrasound image analysis of effusion and synovial hypertrophy in knee osteoarthritisKey messages

Robert Dima,
Trevor B. Birmingham,
Holly T. Philpott,
Dianne Bryant,
Aaron Fenster,
C. Thomas Appleton

Affiliations

Robert Dima: Faculty of Health Sciences, University of Western Ontario, London, ON, N6G 1H1, Canada; Bone and Joint Institute, University of Western Ontario, London Health Sciences Centre-University Hospital, London, ON, N6A 5B5, Canada
Trevor B. Birmingham: Faculty of Health Sciences, University of Western Ontario, London, ON, N6G 1H1, Canada; Bone and Joint Institute, University of Western Ontario, London Health Sciences Centre-University Hospital, London, ON, N6A 5B5, Canada
Holly T. Philpott: Faculty of Health Sciences, University of Western Ontario, London, ON, N6G 1H1, Canada; Bone and Joint Institute, University of Western Ontario, London Health Sciences Centre-University Hospital, London, ON, N6A 5B5, Canada
Dianne Bryant: Faculty of Health Sciences, University of Western Ontario, London, ON, N6G 1H1, Canada; Bone and Joint Institute, University of Western Ontario, London Health Sciences Centre-University Hospital, London, ON, N6A 5B5, Canada
Aaron Fenster: Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, N6A 5C1, Canada; Centre for Medical Imaging, Robarts Research Institute, London, ON, N6A 5K8, Canada
C. Thomas Appleton: Bone and Joint Institute, University of Western Ontario, London Health Sciences Centre-University Hospital, London, ON, N6A 5B5, Canada; Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, N6A 5C1, Canada; Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, N6A 5C1, Canada; Corresponding author. SJHC Rheumatology Centre, 268 Grosvenor St., London, ON, N6A 4V2, Canada

Journal volume & issue: Vol. 5, no. 2
p. 100356

Abstract

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Objective: Effusion-synovitis is related to pain and progression in knee osteoarthritis (OA), but current gold standard ultrasound (US) measures are limited to semi-quantitative grading of joint distension or 1-dimensional thickness measures. A novel quantitative 2-dimensional image analysis methodology is applied to US images of effusion-synovitis; reliability and concurrent validity was assessed in patients with knee OA. Methods: Cross sectional analysis of US images collected from 51 patients with symptomatic knee OA were processed in ImageJ and segmented in 3DSlicer to produce a binary mask of the supra-patellar synovitis region of interest (ROI). Area measures (mm2) of total synovitis, effusion and hypertrophy components were exported. Intra-rater reliability and test-retest reliability (1–14 days washout) were estimated with intra-class correlation coefficients (ICCs). Concurrent validity was measured by Spearman correlations between quantitative measures and gold standard OMERACT and caliper measurements of synovitis. Results: Intra-rater reliability for hypertrophy area was estimated at 0.98, 0.99 for effusion area, and 0.99 for total synovitis area. The test-retest reliability for total synovitis area was 0.63 (SEM 87.8 mm2), 0.59 for hypertrophy area (SEM 21.0 mm2), and 0.64 for effusion area (SEM 73.8 mm2). Correlation between total synovitis area and OMERACT grade was 0.84, 0.81 between total synovitis area and effusion-synovitis calipers, and 0.81 between total effusion area and effusion calipers. Conclusion: This new research tool for image analysis demonstrated excellent intra-rater reliability, good concurrent validity, and moderate test-retest reliability. Quantitative 2D US measures of effusion-synovitis and its individual components may enhance the study and management of knee OA.

Published in Osteoarthritis and Cartilage Open

ISSN: 2665-9131 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the musculoskeletal system
Website: https://www.journals.elsevier.com/osteoarthritis-and-cartilage-open/

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