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Ultrasound in the evaluation of enthesitis status and perspectives 英文参考文献
Gandjbakhchetal.ArthritisResearchTherapy2011,13:R188
/content/13/6/R188
RESEARCH ARTICLE
OpenAccess
Ultrasoundintheevaluationofenthesitis:status
andperspectives
FrédériqueGandjbakhch1,LeneTerslev2,FredrickJoshua3,RichardJWakefield4,EsperanzaNaredo5and
MariaAntoniettaD’Agostino6*,forOMERACTUltrasoundTaskForce
Abstract
Introduction:Anincreasingnumberofstudieshaveappliedultrasoundtotheevaluationofenthesesin
spondyloarthritispatients.However,noclearagreementexistsonthedefinitionofenthesitis,onthenumberand
choiceofenthesestoexamineandonultrasoundtechnique,whichmayallaffecttheresultsoftheexamination.
Theobjectivesofthisstudyweretofirstdeterminethelevelofhomogeneityintheultrasounddefinitionsforthe
principallesionsofenthesitisinthepublishedliteratureandsecond,toevaluatethemetricpropertiesof
ultrasoundfordetectingenthesitisaccordingtotheOMERACTfilter.
Methods:SearchwasperformedinPUBMEDandEMBASE.Bothgrey-scaleandDopplerdefinitionsofenthesitis,
includingdescribingfeaturesofenthesitis,werecollectedandmetrologicalqualitiesofstudieswereassessed.
Results:Afterselection,48articleswereanalyzed.Thedefinitionofultrasoundenthesitisandelementaryfeatures
variedamongauthors.Grey-scaleenthesitiswascharacterizedbyincreasingthickness(94%ofstudies),
hypoechogenicity(83%),enthesophytes(69%),erosions(67%),calcifications(52%),associatedbursitis(46%)and
corticalirregularities(29%).Only46%ofstudiesreportedtheuseofDoppler.Highdiscrepancieswereobservedon
frequency,typeofprobeandDopplermodeused.Faceandcontentvaliditywerethemostfrequentlyevaluated
criteria(43%)followedbyreliability(29%)andresponsiveness(19%).
Conclusions:Ultrasoundhasevidencetosupportface,contentvalidityandreliabilityfortheevaluationof
enthesitis,thoughthereisalackofwell-reportedmethodologyinmostofthestudies.Consensusonelementary
lesionsandstandardizationofexamisneededtodeterminetheultrasounddefinitionofenthesitisingrey-scale
andinDopplerforfutureapplications.
Keywords:Systematicliteraturereview,scoringsystem,ultrasound,powerDopple
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