The assessment of lesions of the Achilles tendon by ultrasound imaging in inflammatory arthritis: A systematic review and meta-analysis

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dc.contributor.author Carroll, M en
dc.contributor.author Dalbeth, Nicola en
dc.contributor.author Boocock, M en
dc.contributor.author Rome, K en
dc.date.accessioned 2015-07-24T00:27:07Z en
dc.date.issued 2015-03 en
dc.identifier.citation Seminars in arthritis and rheumatism, 2015, 45 (1), pp. 103 - 114 (12) en
dc.identifier.issn 0049-0172 en
dc.identifier.uri http://hdl.handle.net/2292/26403 en
dc.description.abstract OBJECTIVE: Ultrasound (US) is a highly sensitive, reliable and non-invasive tool, which allows for the assessment of lesions of tendons and entheseal sites. The aim of this systematic review and meta-analysis is to identify differences in US lesions of the Achilles tendon (AT) between people with inflammatory arthritis (IA) and healthy controls. METHODS: An electronic literature search was performed on Medline, CINAHL, SportDiscus and The Cochrane Library. Methodological quality was assessed using a modified Quality Index. Odds ratios with 95% confidence intervals (CI) were determined. Meta-analysis was conducted on those studies that were considered to be homogenous. RESULTS: A total of 13 high-to-medium quality studies met the inclusion criteria. The majority of studies reported US lesions in spondyloarthropathy (SpA), with limited evidence for other forms of IA. US lesions were not consistently defined with regard to Outcome Measures in Rheumatology Clinical Trials (OMERACT) definitions, and numerous scoring systems were used across the majority of studies. The mean AT thickness at the enthesis in people with SpA was 0.54mm thicker (95% CI: 0.10-0.97mm) with more frequent erosions in people with SpA (odds ratio = 7.43, 95% CI: 1.99-27.77, P = 0.003) and rheumatoid arthritis (RA) (odds ratio = 9.60, 95% CI: 1.23-74.94, P = 0.03), compared to controls. There was no significant difference in the frequency of enthesophyte formation in people with SpA compared to the controls (odds ratio = 2.48, 95% CI: 0.64-9.70, P = 0.19). CONCLUSIONS: The systematic review identified that a majority of studies reporting US lesions were in SpA, but limited evidence relating to other forms of IA. Consistent application of the OMERACT US definitions and scoring of US lesions is required in future studies of AT disease in IA. Further work is also required to distinguish between US lesions reflective of inflammation and structural damage. en
dc.language English en
dc.publisher Elsevier en
dc.relation.ispartofseries Seminars in arthritis and rheumatism en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from http://www.sherpa.ac.uk/romeo/issn/0049-0172/ http://www.elsevier.com/about/company-information/policies/copyright en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.subject Ultrasound en
dc.subject Achilles tendon en
dc.subject Spondyloarthropathy en
dc.subject Rheumatoid arthritis en
dc.title The assessment of lesions of the Achilles tendon by ultrasound imaging in inflammatory arthritis: A systematic review and meta-analysis en
dc.type Journal Article en
dc.identifier.doi 10.1016/j.semarthrit.2015.03.001 en
pubs.issue 1 en
pubs.begin-page 103 en
pubs.volume 45 en
dc.rights.holder Copyright: Elsevier en
dc.identifier.pmid 25910404 en
pubs.author-url http://www.sciencedirect.com/science/article/pii/S0049017215000505 en
pubs.end-page 114 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Review en
pubs.elements-id 486690 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Medicine Department en
dc.identifier.eissn 1532-866X en
pubs.record-created-at-source-date 2015-07-24 en
pubs.dimensions-id 25910404 en


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