A new and simplified comprehensive ultrasound protocol of haemophilic joints: the Universal Simplified Ultrasound (US-US) protocol. Issue 11 (November 2019)

• Record Type: Journal Article
• Authors: Kandagaddala, M.; Sundaramoorthy, M.; Keshava, S.N.; Gibikote, S.; Mahata, K.M.; Kavitha, M.L.; Poonnoose, P.; Srivastava, A.
• Is Part Of: Clinical radiology. Volume 74:Issue 11(2019)
• Page Start: 897.e9
• Page End: 897.e16
• Publication Date: 2019-11
• Subjects: Medical radiology -- Periodicals; Radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiology -- Periodicals; Societies, Medical -- Periodicals; Medical radiology; Radiotherapy; Electronic journals; Periodicals; 616.0757
• DOI: 10.1016/j.crad.2019.07.018
• Languages: English
• ISSNs: 0009-9260

Abstract

Abstract : AIM: To present a new protocol to optimise ultrasound (US) assessment of haemophilic arthropathy. MATERIALS AND METHODS: Ultrasound of haemophilic arthropathy joints was performed using three different ultrasound protocols, namely, the Toronto-Vellore Comprehensive Ultrasound (TVC-US) protocol, the Haemophilia Early Arthropathy Detection with Ultrasound (HEAD-US), and the newly developed Universal Simplified Ultrasound (US-US) protocol. Synovial hypertrophy, haemosiderin deposition, effusion, erosion, and cartilage loss were evaluated in 20 joints. The reliability and diagnostic efficiency of these protocols was compared using magnetic resonance imaging (MRI). RESULTS: The correlation between the TVC-US and US-US protocols for synovial hypertrophy was excellent: kappa significance (KS) was 1, but was substantial (KS=0.65) with the HEAD-US protocol. For effusion, both the TVC-US and the HEAD-US protocols had substantial correlation with the US-US protocol (KS=0.7 and 0.6 respectively). The correlation for erosion and cartilage loss was excellent between the TVC-US and the US-US with MRI (KS=1), but poor (KS=0) with the HEAD-US protocol. The US-US protocol also had good interobserver agreement (KS=1). CONCLUSION: The accuracy of the US-US protocol is comparable to the TVC-US protocol and MRI and is superior to the HEAD-US protocol in the assessment of haemophilic arthropathy. Highlights: Ultrasound is less expensive, avoids radiation and detects arthropathy changes before they are seen on the plain radiograph. Comprehensive US protocols are elaborate and time consuming and POC US protocols have risk of missing crucial findings. US-US protocol is faster, has the advantage of retaining information like comprehensive protocol and is comparable with MRI.