Ultrasound in the diagnosis of calcium pyrophosphate dihydrate deposition disease. A systematic literature review and a meta-analysis

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SONOGRAPHIC EVALUATION OF FEMORAL CONDYLAR CARTILAGE IN OSTEOARTHRITIS AND RHEUMATOID-ARTHRITIS

Employing a real-time sonographic scanner with a 5 MHz linear probe, the articular cartilage of the knee was studied in four groups of subjects: normal subjects aged 18-36 years and 50-63 years, patients with rheumatoid arthritis (RA) and patients with osteoarthritis (OA). Cartilage thickness was diminished both in RA and in OA knees compared to the two groups of normal joints, even if in RA the reduction was less. The cartilage surface appeared irregular more frequently in OA than in RA. Our survey suggests that the sonographic technique is a useful, non-invasive diagnostic method to study the articular cartilage of the knee

How does a cadaver model work for testing ultrasound diagnostic capability for rheumatic-like tendon damage?

To establish whether a cadaver model can serve as an effective surrogate for the detection of tendon damage characteristic of rheumatoid arthritis (RA). In addition, we evaluated intraobserver and interobserver agreement in the grading of RA-like tendon tears shown by US, as well as the concordance between the US findings and the surgically induced lesions in the cadaver model. RA-like tendon damage was surgically induced in the tibialis anterior tendon (TAT) and tibialis posterior tendon (TPT) of ten ankle/foot fresh-frozen cadaveric specimens. Of the 20 tendons examined, six were randomly assigned a surgically induced partial tear; six a complete tear; and eight left undamaged. Three rheumatologists, experts in musculoskeletal US, assessed from 1 to 5 the quality of US imaging of the cadaveric models on a Likert scale. Tendons were then categorized as having either no damage, (0); partial tear, (1); or complete tear (2). All 20 tendons were blindly and independently evaluated twice, over two rounds, by each of the three observers. Overall, technical performance was satisfactory for all items in the two rounds (all values over 2.9 in a Likert scale 1-5). Intraobserver and interobserver agreement for US grading of tendon damage was good (mean κ values 0.62 and 0.71, respectively), with greater reliability found in the TAT than the TPT. Concordance between US findings and experimental tendon lesions was acceptable (70-100 %), again greater for the TAT than for the TPT. A cadaver model with surgically created tendon damage can be useful in evaluating US metric properties of RA tendon lesions