EVALUATION OF 3D ULTRASOUND AS A TOOL TO EXAMINE SYNOVITIS VOLUME AND MORPHOLOGY IN RELATION TO PATIENT-REPORTED OUTCOMES
Notice bibliographique
Résumé
Radiography is the primary imaging tool used to assess and monitor osteoarthritis (OA) in the first carpometacarpal joint (CMC1). However, studies have reported discrepancies between radiographic evidence of OA and patient-reported symptoms such as pain and disability. These discrepancies have been attributed to the lack of soft-tissue contrast associated with radiography in addition to the heterogeneous nature of osteoarthritis as a disease1. Synovitis has been associated with pain and disability and has been proven to be a driver of osteoarthritis disease progression2. 3D ultrasound has been validated for measuring synovial tissue volume in CMC1 OA patient, more work is required to examine sonographic features associated with CMC1 OA in a cohort of patients, including effusion morphology and tissue quality. Nine-teen CMC1 OA patients were recruited by an experienced hand surgeon and a rheumatologist. A 3D ultrasound (3D US) device and a 14L-5 linear probe were used to acquire 3D US image of the CMC1 joint of these patients. 2D US images were acquired and graded using the Outcome Measures in Rheumatology (OMERACT) semi-quantitative grading scales. Pain and disability interference was quantified using the Australian Canadian Hand Osteoarthritis Index. A two-point pinch grip test was conducted to determine grip force. A descriptive analysis was used to describe observed changes in synovial tissue morphology and volume as various imaging grading scales differ, and how these changes are related to outcomes of pain and functional strength. Three distinct OA phenotypes were distinguished by synovial tissue margin properties, synovial tissue volume, and pathophysiological appearance (effusion vs. hypertrophy) as can be seen in Table 1. Patients who presented with moderate synovial tissue volumes comprised predominately of synovial effusion (effusion dominant) had the lowest average pain interference scores and highest functional scores. These patients presented with uniform concave morphology of their joint effusion. In comparison, the second group of patients presented with more diffuse effusion morphology and increased hypertrophic tissue. These patients also had increased pain interference scores and decreased pinch grip values (Table 1). The last group of patients presented with predominantly osteochondral pathology with increased osteophyte presentation, decreased joint space, and decreased synovial tissue volumes. These patients also had the highest pain interference scores and weakest pinch grip forces (Fig.1). The results of this study indicate that morphological differences between signs of synovitis demonstrate that the relationship between disease progression, patient-related outcomes, and image-based evidence of OA in the CMC1 joint is complex. The structures involved change as the disease progresses to more severe stages as well as between bouts of inflammation and varies between patients. 3D US can provide potentially valuable imaging characteristics for monitoring OA. For any figures or tables, please contact the authors directly.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».