Ultrasound imaging in patients with hip pain and suspected hip osteoarthritis: an inter-rater and intra-rater reliability study
ObjectivesThe objectives of this study were to asses (1) inter-rater and intrarater reliability of ultrasound imaging in patients with hip osteoarthritis, and (2) agreement between ultrasound and X-ray findings of hip osteoarthritis using validated Outcome Measures in Rheumatology ultrasound definit...
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| Veröffentlicht in: | BMJ open 2020-11, Vol.10 (11), p.e038643-e038643 |
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| creator | Clausen, Stine Kjær, Søren Fredberg, Ulrich Terslev, Lene Hartvigsen, Jan Arnbak, Bodil |
| description | ObjectivesThe objectives of this study were to asses (1) inter-rater and intrarater reliability of ultrasound imaging in patients with hip osteoarthritis, and (2) agreement between ultrasound and X-ray findings of hip osteoarthritis using validated Outcome Measures in Rheumatology ultrasound definitions for pathology.DesignAn inter-rater and intrarater reliability study.SettingA single-centre study conducted at a regional hospital.Participants50 patients >39 years of age referred for radiography due to hip pain and suspected hip osteoarthritis were included. Exclusion criteria were previous hip surgery in the painful hip, suspected fracture or malignant changes in the hip.InterventionBilateral ultrasound examinations (n=92) were performed continuously by two experienced operators blinded to clinical information and other imaging findings. After 4–6 weeks, one operator reassessed the images. X-rays were assessed by a third imaging specialist.Primary and secondary outcome measuresInter-rater and intrarater reliability and agreement between ultrasound imaging and X-ray were assessed using Cohen’s ordinal kappa statistics for binary categorical variables and weighted kappa for ordered categorical variables.ResultsKappa values (κ) for inter-rater reliability were 0.9 and 0.8 for hip effusion/synovitis and osteoarthritis grading, respectively. For acetabular and femoral osteophytes, femoral cartilage changes and labrum changes κ ranged from 0.4 to 0.7. Intrarater reliability had κ equal or higher compared with inter-rater reliability. Agreement between ultrasound and X-ray findings ranged from κ=0.2 to κ=0.5.ConclusionThis study demonstrated substantial to almost perfect reliability on the most common ultrasound findings related to hip osteoarthritis and osteoarthritis grading. Agreement on the grade of osteoarthritis between ultrasound and X-ray was moderate. Overall, these results support ultrasound imaging as a reliable tool in the assessment of hip osteoarthritis. |
| doi_str_mv | 10.1136/bmjopen-2020-038643 |
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Exclusion criteria were previous hip surgery in the painful hip, suspected fracture or malignant changes in the hip.InterventionBilateral ultrasound examinations (n=92) were performed continuously by two experienced operators blinded to clinical information and other imaging findings. After 4–6 weeks, one operator reassessed the images. X-rays were assessed by a third imaging specialist.Primary and secondary outcome measuresInter-rater and intrarater reliability and agreement between ultrasound imaging and X-ray were assessed using Cohen’s ordinal kappa statistics for binary categorical variables and weighted kappa for ordered categorical variables.ResultsKappa values (κ) for inter-rater reliability were 0.9 and 0.8 for hip effusion/synovitis and osteoarthritis grading, respectively. For acetabular and femoral osteophytes, femoral cartilage changes and labrum changes κ ranged from 0.4 to 0.7. Intrarater reliability had κ equal or higher compared with inter-rater reliability. Agreement between ultrasound and X-ray findings ranged from κ=0.2 to κ=0.5.ConclusionThis study demonstrated substantial to almost perfect reliability on the most common ultrasound findings related to hip osteoarthritis and osteoarthritis grading. Agreement on the grade of osteoarthritis between ultrasound and X-ray was moderate. Overall, these results support ultrasound imaging as a reliable tool in the assessment of hip osteoarthritis.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2020-038643</identifier><identifier>PMID: 33154052</identifier><language>eng</language><publisher>England: British Medical Journal Publishing Group</publisher><subject>Arthralgia ; Arthritis ; Bones ; Bursitis ; Cartilage ; diagnostic radiology ; hip ; Humans ; Medical diagnosis ; Observer Variation ; Osteoarthritis ; Osteoarthritis, Hip - diagnostic imaging ; Pain ; Pathology ; Patients ; Questionnaires ; Radiology and Imaging ; Reproducibility of Results ; Rheumatology ; Statistical analysis ; Ultrasonic imaging ; Ultrasonography ; ultrasound ; X-rays</subject><ispartof>BMJ open, 2020-11, Vol.10 (11), p.e038643-e038643</ispartof><rights>Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2020 Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b578t-f5877f8ef15cc758b0cd153a9e29c1b69ac355cac1b8828c5e2e034e236b17593</citedby><cites>FETCH-LOGICAL-b578t-f5877f8ef15cc758b0cd153a9e29c1b69ac355cac1b8828c5e2e034e236b17593</cites><orcidid>0000-0002-8632-4596</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://bmjopen.bmj.com/content/10/11/e038643.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://bmjopen.bmj.com/content/10/11/e038643.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,27530,27531,27905,27906,53772,53774,55331,77350,77381,77409,77435</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33154052$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Clausen, Stine</creatorcontrib><creatorcontrib>Kjær, Søren</creatorcontrib><creatorcontrib>Fredberg, Ulrich</creatorcontrib><creatorcontrib>Terslev, Lene</creatorcontrib><creatorcontrib>Hartvigsen, Jan</creatorcontrib><creatorcontrib>Arnbak, Bodil</creatorcontrib><title>Ultrasound imaging in patients with hip pain and suspected hip osteoarthritis: an inter-rater and intra-rater reliability study</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><addtitle>BMJ Open</addtitle><description>ObjectivesThe objectives of this study were to asses (1) inter-rater and intrarater reliability of ultrasound imaging in patients with hip osteoarthritis, and (2) agreement between ultrasound and X-ray findings of hip osteoarthritis using validated Outcome Measures in Rheumatology ultrasound definitions for pathology.DesignAn inter-rater and intrarater reliability study.SettingA single-centre study conducted at a regional hospital.Participants50 patients >39 years of age referred for radiography due to hip pain and suspected hip osteoarthritis were included. Exclusion criteria were previous hip surgery in the painful hip, suspected fracture or malignant changes in the hip.InterventionBilateral ultrasound examinations (n=92) were performed continuously by two experienced operators blinded to clinical information and other imaging findings. After 4–6 weeks, one operator reassessed the images. X-rays were assessed by a third imaging specialist.Primary and secondary outcome measuresInter-rater and intrarater reliability and agreement between ultrasound imaging and X-ray were assessed using Cohen’s ordinal kappa statistics for binary categorical variables and weighted kappa for ordered categorical variables.ResultsKappa values (κ) for inter-rater reliability were 0.9 and 0.8 for hip effusion/synovitis and osteoarthritis grading, respectively. For acetabular and femoral osteophytes, femoral cartilage changes and labrum changes κ ranged from 0.4 to 0.7. Intrarater reliability had κ equal or higher compared with inter-rater reliability. Agreement between ultrasound and X-ray findings ranged from κ=0.2 to κ=0.5.ConclusionThis study demonstrated substantial to almost perfect reliability on the most common ultrasound findings related to hip osteoarthritis and osteoarthritis grading. Agreement on the grade of osteoarthritis between ultrasound and X-ray was moderate. Overall, these results support ultrasound imaging as a reliable tool in the assessment of hip osteoarthritis.</description><subject>Arthralgia</subject><subject>Arthritis</subject><subject>Bones</subject><subject>Bursitis</subject><subject>Cartilage</subject><subject>diagnostic radiology</subject><subject>hip</subject><subject>Humans</subject><subject>Medical diagnosis</subject><subject>Observer Variation</subject><subject>Osteoarthritis</subject><subject>Osteoarthritis, Hip - diagnostic imaging</subject><subject>Pain</subject><subject>Pathology</subject><subject>Patients</subject><subject>Questionnaires</subject><subject>Radiology and Imaging</subject><subject>Reproducibility of Results</subject><subject>Rheumatology</subject><subject>Statistical analysis</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography</subject><subject>ultrasound</subject><subject>X-rays</subject><issn>2044-6055</issn><issn>2044-6055</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNUk1v1DAQtRCIVqW_AAlF4sIlrT8ThwMSqvioVIkLPVuOM9n1KhsH2wHtib_O7GZZWg4IH-yZ8XtPM_Yj5CWjV4yJ6rrdbsIEY8kppyUVupLiCTnnVMqyoko9fRCfkcuUNhSXVI1S_Dk5E4IpSRU_Jz_vhxxtCvPYFX5rV35cFX4sJps9jDkVP3xeF2s_YQXLFlFpThO4DN2hHFKGYGNeR599eosIpGeIZbS4HwiYR3vMIwzetn7weVekPHe7F-RZb4cEl8fzgtx__PD15nN59-XT7c37u7JVtc5lr3Rd9xp6ppyrlW6p65gStgHeONZWjXVCKWcx1pprp4ADFRK4qFpWq0ZckNtFtwt2Y6aIs8adCdabQyHElcEpvBvAoIhuRE81o5UEQTU41XW1aztwte4tar1btKa53ULnYD_g8Ej08c3o12YVvpu6kpWQEgXeHAVi-DZDymbrk4NhsCOEORkulcY_pYoi9PVf0E2Y44hPZXilldCc0T1KLCgXQ0oR-lMzjJq9X8zRL2bvF7P4BVmvHs5x4vx2BwKuFgCy_1Px-g_h1Oi_GL8Afp3eEg</recordid><startdate>20201105</startdate><enddate>20201105</enddate><creator>Clausen, Stine</creator><creator>Kjær, Søren</creator><creator>Fredberg, Ulrich</creator><creator>Terslev, Lene</creator><creator>Hartvigsen, Jan</creator><creator>Arnbak, Bodil</creator><general>British Medical Journal Publishing Group</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-8632-4596</orcidid></search><sort><creationdate>20201105</creationdate><title>Ultrasound imaging in patients with hip pain and suspected hip osteoarthritis: an inter-rater and intra-rater reliability study</title><author>Clausen, Stine ; Kjær, Søren ; Fredberg, Ulrich ; Terslev, Lene ; Hartvigsen, Jan ; Arnbak, Bodil</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b578t-f5877f8ef15cc758b0cd153a9e29c1b69ac355cac1b8828c5e2e034e236b17593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Arthralgia</topic><topic>Arthritis</topic><topic>Bones</topic><topic>Bursitis</topic><topic>Cartilage</topic><topic>diagnostic radiology</topic><topic>hip</topic><topic>Humans</topic><topic>Medical diagnosis</topic><topic>Observer Variation</topic><topic>Osteoarthritis</topic><topic>Osteoarthritis, Hip - diagnostic imaging</topic><topic>Pain</topic><topic>Pathology</topic><topic>Patients</topic><topic>Questionnaires</topic><topic>Radiology and Imaging</topic><topic>Reproducibility of Results</topic><topic>Rheumatology</topic><topic>Statistical analysis</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography</topic><topic>ultrasound</topic><topic>X-rays</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Clausen, Stine</creatorcontrib><creatorcontrib>Kjær, Søren</creatorcontrib><creatorcontrib>Fredberg, Ulrich</creatorcontrib><creatorcontrib>Terslev, Lene</creatorcontrib><creatorcontrib>Hartvigsen, Jan</creatorcontrib><creatorcontrib>Arnbak, Bodil</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMJ open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Clausen, Stine</au><au>Kjær, Søren</au><au>Fredberg, Ulrich</au><au>Terslev, Lene</au><au>Hartvigsen, Jan</au><au>Arnbak, Bodil</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ultrasound imaging in patients with hip pain and suspected hip osteoarthritis: an inter-rater and intra-rater reliability study</atitle><jtitle>BMJ open</jtitle><stitle>BMJ Open</stitle><addtitle>BMJ Open</addtitle><date>2020-11-05</date><risdate>2020</risdate><volume>10</volume><issue>11</issue><spage>e038643</spage><epage>e038643</epage><pages>e038643-e038643</pages><issn>2044-6055</issn><eissn>2044-6055</eissn><abstract>ObjectivesThe objectives of this study were to asses (1) inter-rater and intrarater reliability of ultrasound imaging in patients with hip osteoarthritis, and (2) agreement between ultrasound and X-ray findings of hip osteoarthritis using validated Outcome Measures in Rheumatology ultrasound definitions for pathology.DesignAn inter-rater and intrarater reliability study.SettingA single-centre study conducted at a regional hospital.Participants50 patients >39 years of age referred for radiography due to hip pain and suspected hip osteoarthritis were included. Exclusion criteria were previous hip surgery in the painful hip, suspected fracture or malignant changes in the hip.InterventionBilateral ultrasound examinations (n=92) were performed continuously by two experienced operators blinded to clinical information and other imaging findings. After 4–6 weeks, one operator reassessed the images. X-rays were assessed by a third imaging specialist.Primary and secondary outcome measuresInter-rater and intrarater reliability and agreement between ultrasound imaging and X-ray were assessed using Cohen’s ordinal kappa statistics for binary categorical variables and weighted kappa for ordered categorical variables.ResultsKappa values (κ) for inter-rater reliability were 0.9 and 0.8 for hip effusion/synovitis and osteoarthritis grading, respectively. For acetabular and femoral osteophytes, femoral cartilage changes and labrum changes κ ranged from 0.4 to 0.7. Intrarater reliability had κ equal or higher compared with inter-rater reliability. Agreement between ultrasound and X-ray findings ranged from κ=0.2 to κ=0.5.ConclusionThis study demonstrated substantial to almost perfect reliability on the most common ultrasound findings related to hip osteoarthritis and osteoarthritis grading. Agreement on the grade of osteoarthritis between ultrasound and X-ray was moderate. Overall, these results support ultrasound imaging as a reliable tool in the assessment of hip osteoarthritis.</abstract><cop>England</cop><pub>British Medical Journal Publishing Group</pub><pmid>33154052</pmid><doi>10.1136/bmjopen-2020-038643</doi><orcidid>https://orcid.org/0000-0002-8632-4596</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Arthralgia Arthritis Bones Bursitis Cartilage diagnostic radiology hip Humans Medical diagnosis Observer Variation Osteoarthritis Osteoarthritis, Hip - diagnostic imaging Pain Pathology Patients Questionnaires Radiology and Imaging Reproducibility of Results Rheumatology Statistical analysis Ultrasonic imaging Ultrasonography ultrasound X-rays |
| title | Ultrasound imaging in patients with hip pain and suspected hip osteoarthritis: an inter-rater and intra-rater reliability study |
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