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Ikeda K, Narita A, Ogasawara M, Ohno S, Kawahito Y, Kawakami A, Ito H, Matsushita I, Suzuki T, Misaki K, Ogura T, Kamishima T, Seto Y, Nakahara R, Kaneko A, Nakamura T, Henmi M, Fukae J, Nishida K, Sumida T, Koike T. Consensus-based identification of factors related to false-positives in ultrasound scanning of synovitis and tenosynovitis. Mod Rheumatol 2015; 26:9-14. [PMID: 26382930 DOI: 10.3109/14397595.2015.1091123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION We aimed to identify causes of false-positives in ultrasound scanning of synovial/tenosynovial/bursal inflammation and provide corresponding imaging examples. METHODS We first performed systematic literature review to identify previously reported causes of false-positives. We next determined causes of false-positives and corresponding example images for educational material through Delphi exercises and discussion by 15 experts who were an instructor and/or a lecturer in the 2013 advanced course for musculoskeletal ultrasound organized by Japan College of Rheumatology Committee for the Standardization of Musculoskeletal Ultrasonography. RESULTS Systematic literature review identified 11 articles relevant to sonographic false-positives of synovial/tenosynovial inflammation. Based on these studies, 21 candidate causes of false-positives were identified in the consensus meeting. Of these items, 11 achieved a predefined consensus (≥ 80%) in Delphi exercise and were classified as follows: (I) Gray-scale assessment [(A) non-specific synovial findings and (B) normal anatomical structures which can mimic synovial lesions due to either their low echogenicity or anisotropy]; (II) Doppler assessment [(A) Intra-articular normal vessels and (B) reverberation)]. Twenty-four corresponding examples with 49 still and 23 video images also achieved consensus. CONCLUSIONS Our study provides a set of representative images that can help sonographers to understand false-positives in ultrasound scanning of synovitis and tenosynovitis.
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Affiliation(s)
- Kei Ikeda
- a Department of Allergy and Clinical Immunology , Chiba University Hospital , Chiba , Japan
| | - Akihiro Narita
- b Hokkaido Medical Center for Rheumatic Diseases , Sapporo , Japan
| | - Michihiro Ogasawara
- c Department of Internal Medicine and Rheumatology , Juntendo University Faculty of Medicine , Tokyo , Japan
| | - Shigeru Ohno
- d Center for Rheumatic Diseases, Yokohama City University Medical Center , Yokohama , Japan
| | - Yutaka Kawahito
- e Department of Inflammation and Immunology , Kyoto Prefectural University of Medicine , Kyoto , Japan
| | - Atsushi Kawakami
- f Unit of Translational Medicine, Department of Immunology and Rheumatology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Hiromu Ito
- g Department of Orthopaedic Surgery , Kyoto University Graduate School of Medicine , Kyoto , Japan
| | - Isao Matsushita
- h Department of Orthopaedic Surgery , University of Toyama , Toyama , Japan
| | - Takeshi Suzuki
- i Division of Allergy and Rheumatology , Japanese Red Cross Medical Center , Tokyo , Japan
| | - Kenta Misaki
- j Department of Endocrinology and Rheumatology , Kurashiki Central Hospital , Kurashiki , Okayama , Japan
| | - Takehisa Ogura
- k Division of Rheumatology , Toho University Ohashi Medical Center , Tokyo , Japan
| | | | - Yohei Seto
- m Department of Rheumatology , Tokyo Women's Medical University Yachiyo Medical Center , Yachiyo , Chiba , Japan
| | - Ryuichi Nakahara
- n Department of Human Morphology , Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine , Okayama , Japan
| | - Atsushi Kaneko
- o Department of Orthopaedic Surgery and Rheumatology , Nagoya Medical Center, National Hospital Organization , Nagoya , Japan
| | - Takayuki Nakamura
- a Department of Allergy and Clinical Immunology , Chiba University Hospital , Chiba , Japan
| | - Mihoko Henmi
- b Hokkaido Medical Center for Rheumatic Diseases , Sapporo , Japan
| | - Jun Fukae
- b Hokkaido Medical Center for Rheumatic Diseases , Sapporo , Japan
| | - Keiichiro Nishida
- n Department of Human Morphology , Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine , Okayama , Japan
| | - Takayuki Sumida
- p Department of Internal Medicine , Faculty of Medicine, University of Tsukuba , Tsukuba , Japan , and
| | - Takao Koike
- q NTT Sapporo Medical Center , Sapporo , Japan
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