Objective: To determine the intra- and interobserver reliability of ultrasound (US)-detected age-related joint vascularization and ossification grading in healthy children. Methods: Following standardized image acquisition and machine setting protocols, 10 international US experts examined 4 joints (wrist, second metacarpophalangeal joint, knee, and ankle) in 12 healthy children (divided into 4 age groups: 2–4, 5–8, 9–12, and 13–16 years). Gray-scale was used to detect the ossification grade, and power Doppler ultrasound (PDUS) was used to detect physiologic vascularization. Ossification was graded from 0 (no ossification) to 3 (complete ossification). A positive PDUS signal was defined as any PDUS signal inside the joint. Kappa statistics were applied for intra- and interobserver reliability. Results: According to the specific joint and age, up to 4 solitary PDUS signals (mean 1.5) were detected within each joint area with predominant localization of the physiologic vascularization in specific anatomic positions: fat pad, epiphysis, physis, and short bone cartilage. The kappa values for ossification grading were 0.87 (range 0.85–0.91) and 0.58 for intra- and interobserver reliability, respectively. The bias-adjusted kappa values for intra- and interobserver reliability were 0.71 (range 0.44–1.00) and 0.69, respectively. Conclusion: Detection of normal findings (i.e., grading of physiologic ossification during skeletal maturation and identification of physiologic vessels) can be highly reliable by using clear definitions and a standardized acquisition protocol. These data will permit development of a reliable and standardized US approach for evaluating pediatric joint pathologies.

Windschall, D., Collado, P., Vojinovic, J., Magni-Manzoni, S., Balint, P., Bruyn, G. A. W., Hernandez-Diaz, C., Nieto, J. C., Ravagnani, V., Tzaribachev, N., Iagnocco, A., D'Agostino, M. A., Naredo, E., Age-Related Vascularization and Ossification of Joints in Children: An International Pilot Study to Test Multiobserver Ultrasound Reliability, <<ARTHRITIS CARE & RESEARCH>>, 2020; 72 (4): 498-506. [doi:10.1002/acr.23335] [http://hdl.handle.net/10807/168595]

Age-Related Vascularization and Ossification of Joints in Children: An International Pilot Study to Test Multiobserver Ultrasound Reliability

D'Agostino, M. A.
Penultimo
Methodology
;
2020

Abstract

Objective: To determine the intra- and interobserver reliability of ultrasound (US)-detected age-related joint vascularization and ossification grading in healthy children. Methods: Following standardized image acquisition and machine setting protocols, 10 international US experts examined 4 joints (wrist, second metacarpophalangeal joint, knee, and ankle) in 12 healthy children (divided into 4 age groups: 2–4, 5–8, 9–12, and 13–16 years). Gray-scale was used to detect the ossification grade, and power Doppler ultrasound (PDUS) was used to detect physiologic vascularization. Ossification was graded from 0 (no ossification) to 3 (complete ossification). A positive PDUS signal was defined as any PDUS signal inside the joint. Kappa statistics were applied for intra- and interobserver reliability. Results: According to the specific joint and age, up to 4 solitary PDUS signals (mean 1.5) were detected within each joint area with predominant localization of the physiologic vascularization in specific anatomic positions: fat pad, epiphysis, physis, and short bone cartilage. The kappa values for ossification grading were 0.87 (range 0.85–0.91) and 0.58 for intra- and interobserver reliability, respectively. The bias-adjusted kappa values for intra- and interobserver reliability were 0.71 (range 0.44–1.00) and 0.69, respectively. Conclusion: Detection of normal findings (i.e., grading of physiologic ossification during skeletal maturation and identification of physiologic vessels) can be highly reliable by using clear definitions and a standardized acquisition protocol. These data will permit development of a reliable and standardized US approach for evaluating pediatric joint pathologies.
2020
Inglese
Windschall, D., Collado, P., Vojinovic, J., Magni-Manzoni, S., Balint, P., Bruyn, G. A. W., Hernandez-Diaz, C., Nieto, J. C., Ravagnani, V., Tzaribachev, N., Iagnocco, A., D'Agostino, M. A., Naredo, E., Age-Related Vascularization and Ossification of Joints in Children: An International Pilot Study to Test Multiobserver Ultrasound Reliability, <<ARTHRITIS CARE & RESEARCH>>, 2020; 72 (4): 498-506. [doi:10.1002/acr.23335] [http://hdl.handle.net/10807/168595]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/168595
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