Ultrasound imaging in patients with hip pain and suspected hip osteoarthritis: an inter-rater and intra-rater reliability study

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DOI

  • Stine Clausen, Faculty of Health Sciences, Institute of Regional Health Services Sciences, University of Southern Denmark, Denmark
  • ,
  • Søren Kjær
  • ,
  • Ulrich Fredberg
  • Lene Terslev, c Center for Rheumatology and Spine Diseases , Copenhagen Center for Arthritis Research, Rigshospitalet , Glostrup , Denmark., Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen
  • ,
  • Jan Hartvigsen, Faculty of Health Sciences, Institute of Regional Health Services Sciences, University of Southern Denmark, Denmark, Nordic Institute of Chiropractic and Clinical Biomechanics
  • ,
  • Bodil Arnbak, Faculty of Health Sciences, Institute of Regional Health Services Sciences, University of Southern Denmark, Denmark, Lillebælt Hospital, Vejle

OBJECTIVES: The objectives of this study were to asses (1) inter-rater and intrarater reliability of ultrasound imaging in patients with hip osteoarthritis, and (2) agreement between ultrasound and X-ray findings of hip osteoarthritis using validated Outcome Measures in Rheumatology ultrasound definitions for pathology.

DESIGN: An inter-rater and intrarater reliability study.

SETTING: A single-centre study conducted at a regional hospital.

PARTICIPANTS: 50 patients >39 years of age referred for radiography due to hip pain and suspected hip osteoarthritis were included. Exclusion criteria were previous hip surgery in the painful hip, suspected fracture or malignant changes in the hip.

INTERVENTION: Bilateral ultrasound examinations (n=92) were performed continuously by two experienced operators blinded to clinical information and other imaging findings. After 4-6 weeks, one operator reassessed the images. X-rays were assessed by a third imaging specialist.

PRIMARY AND SECONDARY OUTCOME MEASURES: Inter-rater and intrarater reliability and agreement between ultrasound imaging and X-ray were assessed using Cohen's ordinal kappa statistics for binary categorical variables and weighted kappa for ordered categorical variables.

RESULTS: Kappa values (κ) for inter-rater reliability were 0.9 and 0.8 for hip effusion/synovitis and osteoarthritis grading, respectively. For acetabular and femoral osteophytes, femoral cartilage changes and labrum changes κ ranged from 0.4 to 0.7. Intrarater reliability had κ equal or higher compared with inter-rater reliability. Agreement between ultrasound and X-ray findings ranged from κ=0.2 to κ=0.5.

CONCLUSION: This study demonstrated substantial to almost perfect reliability on the most common ultrasound findings related to hip osteoarthritis and osteoarthritis grading. Agreement on the grade of osteoarthritis between ultrasound and X-ray was moderate. Overall, these results support ultrasound imaging as a reliable tool in the assessment of hip osteoarthritis.

OriginalsprogEngelsk
Artikelnummere038643
TidsskriftBMJ Open
Vol/bind10
Nummer11
Antal sider8
ISSN2044-6055
DOI
StatusUdgivet - nov. 2020

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