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International multispecialty consensus on how to image, define, and grade ultrasound imaging features of first metatarsophalangeal joint osteoarthritis, a Delphi consensus study

International multispecialty consensus on how to image, define, and grade ultrasound imaging features of first metatarsophalangeal joint osteoarthritis, a Delphi consensus study
International multispecialty consensus on how to image, define, and grade ultrasound imaging features of first metatarsophalangeal joint osteoarthritis, a Delphi consensus study
Objective: To reach consensus concerning which ultrasound imaging features should be assessed and graded, and what ultrasound imaging procedure should be performed when examining osteoarthritic change in the first metatarsophalangeal joint.
Design: An online Delphi study was conducted over four iterative rounds with 16 expert health professionals. Items were scored from 0 to 100 (0 ​= ​not at all important; 100 ​= ​extremely important). Consensus was defined based upon an item receiving a median score of ≥70% acceptance. Items receiving median score of ≤50% were rejected. Items considered ambiguous (median score 51%-69% of acceptance) were assessed in an additional round. A final round determined the content validity of items through calculation of the content validity ratio and content validity index.
Results: Sixteen items were deemed essential, which included osteophytes graded dichotomously, cartilage damage graded continuously, synovitis and joint space narrowing graded on a semiquantitative scale. The panel deemed essential that the first metatarsophalangeal joint start in a neutral position, then move through range of motion for both dorsal and plantar scanning, orientating the probe in longitudinal and in transverse, whilst using first metatarsal head and proximal phalanx as anatomical landmarks. A supine body position was only deemed essential for a dorsal scan and a neutral foot/ankle position was only rated essential for a plantar scan. The content validity index of the 16 essential items was 0.19.
Conclusion: The consensus exercise has identified the essential components the ultrasound imaging acquisition procedure should encompass when examining first metatarsophalangeal joint osteoarthritis.
Foot, Metatarsophalangeal joint, Osteoarthritis, Ultrasound imaging
2665-9131
Molyneux, Prue
aca46efc-cd44-4367-adec-7e457e0ad665
Bowen, Catherine
fd85c3c5-96d9-49b8-86c6-caa94e1a222b
Ellis, Richard
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Rome, Keith
fc9a40cd-cd38-4f5c-b42e-bcb4ef91dd12
Carroll, Matthew
3f70a4eb-4540-4e77-81e2-94ebfdece2a5
Molyneux, Prue
aca46efc-cd44-4367-adec-7e457e0ad665
Bowen, Catherine
fd85c3c5-96d9-49b8-86c6-caa94e1a222b
Ellis, Richard
9dcd8540-150f-4c5f-a659-387097375d75
Rome, Keith
fc9a40cd-cd38-4f5c-b42e-bcb4ef91dd12
Carroll, Matthew
3f70a4eb-4540-4e77-81e2-94ebfdece2a5

Molyneux, Prue, Bowen, Catherine, Ellis, Richard, Rome, Keith and Carroll, Matthew (2023) International multispecialty consensus on how to image, define, and grade ultrasound imaging features of first metatarsophalangeal joint osteoarthritis, a Delphi consensus study. Osteoarthritis and Cartilage Open, 5 (1), [100336]. (doi:10.1016/j.ocarto.2023.100336).

Record type: Article

Abstract

Objective: To reach consensus concerning which ultrasound imaging features should be assessed and graded, and what ultrasound imaging procedure should be performed when examining osteoarthritic change in the first metatarsophalangeal joint.
Design: An online Delphi study was conducted over four iterative rounds with 16 expert health professionals. Items were scored from 0 to 100 (0 ​= ​not at all important; 100 ​= ​extremely important). Consensus was defined based upon an item receiving a median score of ≥70% acceptance. Items receiving median score of ≤50% were rejected. Items considered ambiguous (median score 51%-69% of acceptance) were assessed in an additional round. A final round determined the content validity of items through calculation of the content validity ratio and content validity index.
Results: Sixteen items were deemed essential, which included osteophytes graded dichotomously, cartilage damage graded continuously, synovitis and joint space narrowing graded on a semiquantitative scale. The panel deemed essential that the first metatarsophalangeal joint start in a neutral position, then move through range of motion for both dorsal and plantar scanning, orientating the probe in longitudinal and in transverse, whilst using first metatarsal head and proximal phalanx as anatomical landmarks. A supine body position was only deemed essential for a dorsal scan and a neutral foot/ankle position was only rated essential for a plantar scan. The content validity index of the 16 essential items was 0.19.
Conclusion: The consensus exercise has identified the essential components the ultrasound imaging acquisition procedure should encompass when examining first metatarsophalangeal joint osteoarthritis.

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Accepted/In Press date: 12 January 2023
e-pub ahead of print date: 19 January 2023
Published date: 1 March 2023
Additional Information: © 2023 The Author(s).
Keywords: Foot, Metatarsophalangeal joint, Osteoarthritis, Ultrasound imaging

Identifiers

Local EPrints ID: 476925
URI: http://eprints.soton.ac.uk/id/eprint/476925
ISSN: 2665-9131
PURE UUID: c0efdea9-bb31-4fca-95f0-a87efbee4b53
ORCID for Catherine Bowen: ORCID iD orcid.org/0000-0002-7252-9515

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Date deposited: 19 May 2023 16:43
Last modified: 17 Mar 2024 02:53

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Contributors

Author: Prue Molyneux
Author: Catherine Bowen ORCID iD
Author: Richard Ellis
Author: Keith Rome
Author: Matthew Carroll

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