Category: Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Measurement; International
Objective : To describe the ultrasonographic findings in the hands and feet of asymptomatic volunteers, their association with sociodemographic characteristics, and the interobserver and interobserver concordance of their measurements.
Design : Descriptive and analytical study in which 182 asymptomatic volunteers were included. Two physicians with musculoskeletal radiology experience evaluated the dorsal aspect of 5460 articular recesses using the semiquantitative scale of Szkudlarek and using a linear transducer of 18 mhz.
Setting : Ambulatory care
Participants (or Animals, Specimens, Cadavers) : Convenience sample of 182 asymptomatic volunteers
Interventions : Not applicable
Main Outcome Measure(s) : ultrasonographic findings in the hands and feet of asymptomatic volunteers semiquantitative scale of Szkudlarek.
The median age of the participants was 42 years, 60.4% of them women. In 87% of the volunteers a total of 232 findings were identified, 68.1% corresponded to joint effusion, 29.3% to synovial hypertrophy, 2.1% to erosions and 0.4% to power Doppler. Patients showed higher findings than hands (70.7% vs 29.3%). The joints in which more abnormalities were identified were the first metatarsophalangeal joint (52%), third metatarsophalangeal joint (15%) and radiocarpal joint (9.5%). A positive relationship was found between joint effusion and synovial hypertrophy with age, exclusive manual occupation and working time over ten years. The intraobserver concordance was moderate (Kappa = 0.4591) and the interobserver was mild (Kappa = 0.2155)
Conclusions : In the subjects evaluated, the absence of power Doppler signal, distal radioulnar noncommitment, the absence of synovitis accompanied by erosion, and a greater predominance of slight alterations in the hands, added to the absence of findings at the level of the fifth joint. metatarsal, are potentially specific findings in asymptomatic subjects that deserve to be confirmed as such in future studies
Thomas Torres-Cuenca– PM&R Resident, Universidad Nacional de Colombia, Ibague, Tolima
Carlos Calderón-Cordero– Reumatologist, National University of Colombia, Bucaramanga, Santander
Mónica Rodriguez-Sierra– PM&R PGYI Resident, National University of Colombia, Bogota, Distrito Capital de Bogota
Gerardo Quintana.Lopez– Reumatologist, National University of Colombia, Bogota, Distrito Capital de Bogota
Enrique Calvo-Páramo– Radiologist, National University of Colombia, Bogota, Distrito Capital de Bogota