The University of Southampton
University of Southampton Institutional Repository

Musculoskeletal ultrasound imaging of the plantar forefoot in patients with rheumatoid arthritis: inter-observer agreement between a podiatrist and a radiologist

Musculoskeletal ultrasound imaging of the plantar forefoot in patients with rheumatoid arthritis: inter-observer agreement between a podiatrist and a radiologist
Musculoskeletal ultrasound imaging of the plantar forefoot in patients with rheumatoid arthritis: inter-observer agreement between a podiatrist and a radiologist
Background: The use of musculoskeletal ultrasound (MSUS) in the diagnosis and management of foot and ankle musculoskeletal pathology is increasing. Due to the wide use of MSUS and the depth and breadth of training required new proposals advocate tailored learning of the technique to discrete fields of practice. The aims of the study were to evaluate the inter-observer agreement between a MSUS radiologist and a podiatrist, who had completed basic skills training in MSUS, in the MSUS assessment of the forefoot of patients with Rheumatoid Arthritis.

Methods: A consecutive sample of thirty-two patients with rheumatoid arthritis was assessed for presence of synovitis, erosions and bursitis within the forefoot using MSUS. All MSUS assessments were performed independently on the same day by a podiatrist and one of two Consultant Radiologists experienced in MSUS.

Results: Moderate agreement on image acquisition and interpretation was achieved for bursitis (kappa 0.522; p<0.01) and erosions (kappa 0.636; p<0.01) and fair agreement for synovitis (kappa 0.216; p<0.05) during the primary assessments. Following a further training session, substantial agreement (kappa 0.702) between the two investigators was recorded. The sensitivity of the podiatrist using MSUS was 82.4% for detection of bursitis, 83.0% for detection of erosion and 84.0% for detection of synovitis. Specificity of the podiatrist using MSUS was 88.9% for detection of bursitis, 80.7% for detection of erosion and 35.9% for detection of synovitis.

Conclusions: This study demonstrated good inter-observer agreement between a podiatrist and radiologist on MSUS assessment of the forefoot, particularly for bursitis and erosions, in patients with rheumatoid arthritis. There is scope to further evaluate and consider the role of podiatrists in the MSUS imaging of the foot following appropriate training and also in the development of reliable protocols for MSUS assessment of the foot.

ultrasound, imaging, reliability, podiatry
1757-1146
1-7
Bowen, Catherine J.
fd85c3c5-96d9-49b8-86c6-caa94e1a222b
Dewbury, Keith
8190bf19-f678-4167-bece-d0a514d084e3
Sampson, Madeline
c43d606b-6ae9-445a-b3a5-db03c1b2db36
Sawyer, Sally
9a5a0dbe-11c5-49ad-98fa-8bc6e1ba48ab
Burridge, Jane
0110e9ea-0884-4982-a003-cb6307f38f64
Edwards, Christpher J.
dcb27fec-75ea-4575-a844-3588bcf14106
Arden, Nigel K.
23af958d-835c-4d79-be54-4bbe4c68077f
Bowen, Catherine J.
fd85c3c5-96d9-49b8-86c6-caa94e1a222b
Dewbury, Keith
8190bf19-f678-4167-bece-d0a514d084e3
Sampson, Madeline
c43d606b-6ae9-445a-b3a5-db03c1b2db36
Sawyer, Sally
9a5a0dbe-11c5-49ad-98fa-8bc6e1ba48ab
Burridge, Jane
0110e9ea-0884-4982-a003-cb6307f38f64
Edwards, Christpher J.
dcb27fec-75ea-4575-a844-3588bcf14106
Arden, Nigel K.
23af958d-835c-4d79-be54-4bbe4c68077f

Bowen, Catherine J., Dewbury, Keith, Sampson, Madeline, Sawyer, Sally, Burridge, Jane, Edwards, Christpher J. and Arden, Nigel K. (2008) Musculoskeletal ultrasound imaging of the plantar forefoot in patients with rheumatoid arthritis: inter-observer agreement between a podiatrist and a radiologist. Journal of Foot and Ankle Research, 1 (5), 1-7. (doi:10.1186/1757-1146-1-5).

Record type: Article

Abstract

Background: The use of musculoskeletal ultrasound (MSUS) in the diagnosis and management of foot and ankle musculoskeletal pathology is increasing. Due to the wide use of MSUS and the depth and breadth of training required new proposals advocate tailored learning of the technique to discrete fields of practice. The aims of the study were to evaluate the inter-observer agreement between a MSUS radiologist and a podiatrist, who had completed basic skills training in MSUS, in the MSUS assessment of the forefoot of patients with Rheumatoid Arthritis.

Methods: A consecutive sample of thirty-two patients with rheumatoid arthritis was assessed for presence of synovitis, erosions and bursitis within the forefoot using MSUS. All MSUS assessments were performed independently on the same day by a podiatrist and one of two Consultant Radiologists experienced in MSUS.

Results: Moderate agreement on image acquisition and interpretation was achieved for bursitis (kappa 0.522; p<0.01) and erosions (kappa 0.636; p<0.01) and fair agreement for synovitis (kappa 0.216; p<0.05) during the primary assessments. Following a further training session, substantial agreement (kappa 0.702) between the two investigators was recorded. The sensitivity of the podiatrist using MSUS was 82.4% for detection of bursitis, 83.0% for detection of erosion and 84.0% for detection of synovitis. Specificity of the podiatrist using MSUS was 88.9% for detection of bursitis, 80.7% for detection of erosion and 35.9% for detection of synovitis.

Conclusions: This study demonstrated good inter-observer agreement between a podiatrist and radiologist on MSUS assessment of the forefoot, particularly for bursitis and erosions, in patients with rheumatoid arthritis. There is scope to further evaluate and consider the role of podiatrists in the MSUS imaging of the foot following appropriate training and also in the development of reliable protocols for MSUS assessment of the foot.

Full text not available from this repository.

More information

Submitted date: 16 May 2008
Published date: 28 July 2008
Keywords: ultrasound, imaging, reliability, podiatry

Identifiers

Local EPrints ID: 57975
URI: https://eprints.soton.ac.uk/id/eprint/57975
ISSN: 1757-1146
PURE UUID: 20fd15dd-fbc3-4bdc-b067-78459dd5fa7c
ORCID for Catherine J. Bowen: ORCID iD orcid.org/0000-0002-7252-9515
ORCID for Jane Burridge: ORCID iD orcid.org/0000-0003-3497-6725

Catalogue record

Date deposited: 18 Aug 2008
Last modified: 05 Nov 2019 01:59

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×