Development of a radiographic scoring system for new bone formation in gout

Arthritis Research & Therapy

Anne Horne¹  Nicola Dalbeth¹  Ken Cai¹  Sarah Stewart¹  Lisa K. Stamp²  Anthony Doyle³  Karen Billington⁴  John Ferrier⁴  Yun-Jung Jack Tsai⁴  Thomas Bardin⁵  Chang-Nam Son⁶ 

[1] Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand;Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand;Department of Radiology with Anatomy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand;Department of Radiology, Auckland District Health Board, Auckland, New Zealand;Department of Rheumatology, Hôpital Lariboisière, Paris, France;Keimyung University School of Medicine, Daegu, South Korea;Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand;

关键词: Gout;    New bone formation;    Radiography;   

DOI  :  10.1186/s13075-021-02683-9

来源: Springer

【 摘 要 】

BackgroundFeatures of new bone formation (NBF) are common in tophaceous gout. The aim of this project was to develop a plain radiographic scoring system for NBF in gout.MethodsInformed by a literature review, scoring systems were tested in 80 individual 1st and 5th metatarsophalangeal joints. Plain radiography scores were compared with computed tomography (CT) measurements of the same joints. The best-performing scoring system was then tested in paired sets of hand and foot radiographs obtained over 2 years from an additional 25 patients. Inter-reader reproducibility was assessed using intraclass correlation coefficients (ICC). NBF scores were correlated with plain radiographic erosion scores (using the gout-modified Sharp-van der Heijde system).ResultsFollowing a series of structured reviews of plain radiographs and scoring exercises, a semi-quantitative scoring system for sclerosis and spur was developed. In the individual joint analysis, the inter-observer ICC (95% CI) was 0.84 (0.76–0.89) for sclerosis and 0.81 (0.72–0.87) for spur. Plain radiographic sclerosis and spur scores correlated with CT measurements (r = 0.65–0.74, P < 0.001 for all analyses). For the hand and foot radiograph sets, the inter-observer ICC (95% CI) was 0.94 (0.90–0.98) for sclerosis score and 0.76 (0.65–0.84) for spur score. Sclerosis and spur scores correlated highly with plain radiographic erosion scores (r = 0.87 and 0.71 respectively), but not with change in erosion scores over 2 years (r = −0.04–0.15).ConclusionA semi-quantitative plain radiographic scoring method for the assessment of NBF in gout is feasible, valid, and reproducible. This method may facilitate consistent measurement of NBF in gout.

【 授权许可】

CC BY