Publications by authors named "George A. Bruyn"

Objective: To test the reliability of the Outcome Measures in Rheumatology Giant cell arteritis (GCA) Ultrasonography Score (OGUS) and other composite scores in a patient-based exercise involving experts and non-experts in vascular ultrasonography.

Methods: Six GCA patients were scanned twice (two rounds separated ≥3 hours) by 12 experts and 12 non-experts. Non-experts received 90 min of theoretical and 240 min of practical training between rounds 1 and 2.

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Objectives: The main objective was to generate a GLobal OMERACT Ultrasound DActylitis Score (GLOUDAS) in psoriatic arthritis and to test its reliability. To this end, we assessed the validity, feasibility and applicability of ultrasound assessment of finger entheses to incorporate them into the scoring system.

Methods: The study consisted of a stepwise process.

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Article Synopsis
  • Sjögren's disease (SjD) is a complex autoimmune condition characterized by symptoms like dryness, pain, and fatigue, affecting various organ systems in different ways.
  • The variability in symptoms among patients complicates the development of effective treatments, highlighting the need to better understand the disease.
  • In 2023, the OMERACT SjD Working Group held a hybrid meeting to review research and establish core disease domains that reflect both clinical features and patient experiences, ultimately producing a provisional domain list to address SjD's diversity.
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Objective: To assess the construct validity of the novel Outcome Measures in Rheumatology (OMERACT) ultrasound (US) semiquantitative scoring system for morphological lesions in major salivary glands by comparing it with magnetic resonance imaging (MRI) and unstimulated whole salivary flow rates (U-WSFRs) in patients with primary Sjögren syndrome (pSS).

Methods: Nine sonographers applied the OMERACT 0-3 grayscale scoring system for parotid (PGs) and submandibular glands (SMGs) in 11 patients with pSS who also had MRIs performed. These were evaluated by 2 radiologists using a semiquantitative 0-3 scoring system for morphological lesions.

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Henrik Sjögren was a Swedish ophthalmologist who wrote a dissertation (in German) consisting of a 131-page long monograph on patients who exhibited a constellation of keratitis sicca, xerostomia and arthritis. This article highlights several key moments of his life and work leading to the delineation of a new syndrome.

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Objective: The aim of this exercise from the OMERACT Ultrasound subgroup on Sjögren's syndrome was to develop and assess the reliability of a consensus-based semiquantitative colour Doppler US scoring system for pathologic salivary gland vascularization in patients with primary Sjögren's syndrome (pSS).

Methods: Using the Delphi method, a colour Doppler semiquantitative scoring system for vascularization of bilateral parotid and submandibular glands was developed and tested in static images and on patients (9 pSS patients and 9 sonographers). Intra-reader and inter-reader reliability of grading the salivary glands were computed by weighted Cohen and Light's kappa analysis, respectively.

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Objectives: This study aimed to determine the prevalence of ultrasound-detected tendon abnormalities in healthy subjects (HS) across the age range.

Methods: Adult HS (age 18-80 years) were recruited in 23 international Outcome Measures in Rheumatology ultrasound centres and were clinically assessed to exclude inflammatory diseases or overt osteoarthritis before undergoing a bilateral ultrasound examination of digit flexors (DFs) 1-5 and extensor carpi ulnaris (ECU) tendons to detect the presence of tenosynovial hypertrophy (TSH), tenosynovial power Doppler (TPD) and tenosynovial effusion (TEF), usually considered ultrasound signs of inflammatory diseases. A comparison cohort of patients with rheumatoid arthritis (RA) was taken from the Birmingham Early Arthritis early arthritis inception cohort.

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Objectives: To define chronic ultrasound lesions of the axillary artery (AA) in long-standing giant cell arteritis (GCA) and to evaluate the reliability of the new ultrasound definition in a web-based exercise.

Methods: A structured Delphi, involving an expert panel of the Large Vessel Vasculitis subgroup of the Outcome Measures in Rheumatology (OMERACT) Ultrasound Working Group was carried out. The reliability of the new definition was tested in a 2-round web-based exercise involving 23 experts and using 50 still images each from AA of long-standing and acute GCA patients, as well as 50 images from healthy individuals.

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Article Synopsis
  • The study aimed to standardize and evaluate the reliability of ultrasound for assessing inflammatory and structural lesions in patients with hand osteoarthritis (OA).
  • Key inflammatory lesions identified included synovial hypertrophy, joint effusion, and power Doppler signals, while osteophytes and cartilage defects in specific joints were added as new structural measures.
  • Results showed substantial intra-reader reliability for inflammatory features, though inter-reader reliability was moderate, indicating that further training could enhance consistency in assessments.
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Objective: To produce European League Against Rheumatism (EULAR) recommendations for the reporting of ultrasound studies in rheumatic and musculoskeletal diseases (RMDs).

Methods: Based on the literature reviews and expert opinion (through Delphi surveys), a taskforce of 23 members (12 experts in ultrasound in RMDs, 9 in methodology and biostatistics together with a patient research partner and a health professional in rheumatology) developed a checklist of items to be reported in every RMD study using ultrasound. This checklist was further refined by involving a panel of 79 external experts (musculoskeletal imaging experts, methodologists, journal editors), who evaluated its comprehensibility, feasibility and comprehensiveness.

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Objective: This study aimed to develop (1) a new ultrasound definition for aggregates and (2) a semi-quantitative ultrasound scoring system (0-3) for tophus, double contour and aggregates. Furthermore, the intra- and inter-reader reliabilities of both the re-defined aggregates and the semi-quantitative scoring system were assessed using static image exercises.

Methods: Thirty-seven rheumatologists were invited.

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Background: To assess the reliability of the consensually agreed US definitions of major salivary gland lesions and the US scoring system for salivary gland assessment in patients with SS.

Methods: Nine experienced sonographers scanned and read the US images of both parotid glands (PGs) and submandibular glands (SMGs) in eight patients with primary and secondary SS in two rounds. A consensually agreed four-grade semi-quantitative scoring was applied in B-mode for morphological lesions: grade 0, normal; grade 1, mild inhomogeneity without anechoic or hypoechoic areas; grade 2, moderate inhomogeneity with focal anechoic or hypoechoic areas; grade 3, severe inhomogeneity with diffuse an- or hypoechoic areas occupying the entire gland or fibrous gland.

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Objective: To evaluate the discriminatory ability of ultrasound in calcium pyrophosphate deposition disease (CPPD), using microscopic analysis of menisci and knee hyaline cartilage (HC) as reference standard.

Methods: Consecutive patients scheduled for knee replacement surgery, due to osteoarthritis (OA), were enrolled. Each patient underwent ultrasound examination of the menisci and HC of the knee, scoring each site for presence/absence of CPPD.

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Article Synopsis
  • The CME focuses on the ultrasound anatomy of the enthesis, which is the site where tendons and ligaments attach to bone.
  • Understanding the various diseases related to the enthesis is crucial for accurate diagnosis and patient classification.
  • Importantly, signs of enthesitis do not always indicate the presence of spondyloarthritis.
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CME Sonography 93: Ultrasound of the Enthesis - Not Every "Enthesitis" Signals a Spondyloarthritis In this CME we will focus on the ultrasound anatomy of the enthesis. In addition, we describe the terms enthesopathy and enthesitis and discuss related differential diagnostic considerations. It is important to know all the diseases that can manifest themselves at the enthesis, so that diagnoses can be made, and patients classified correctly.

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Article Synopsis
  • This study investigates the connection between salivary gland ultrasonography (SGUS), salivary flow rate (SFR), and oral health-related quality of life (OHRQOL) in patients with primary Sjögren syndrome (pSS).
  • It involved 66 pSS patients, with SGUS revealing that those with low unstimulated salivary flow showed significantly higher SGUS scores for glandular involvement, indicating worsened salivary gland function.
  • The findings suggest that high SGUS scores correlate with lower SFR and poorer OHRQOL, with specific SGUS features (like homogeneity) being reliable indicators of severely impaired gland function in pSS patients.
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Objectives: To evaluate associations between salivary gland ultrasonography (SGUS) and clinical characteristics, disease activity and outcome in patients with primary Sjögren's syndrome (pSS).

Methods: The parotid and submandibular salivary glands were examined by ultrasonography using two different scoring systems proposed by Hocevar et al. and Milic et al.

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Objective: To provide an overview of the role of lung ultrasound (LUS) in the assessment of interstitial lung disease (ILD) in systemic sclerosis (SSc) and to discuss the state of validation supporting its clinical relevance and application in daily clinical practice.

Methods: Original articles published between January 1997 and October 2017 were included. To identify all available studies, a detailed search pertaining to the topic of review was conducted according to guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA).

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Objective: To identify and synthesize the best available evidence on the application of musculoskeletal (MSK) ultrasound (US) in patients with systemic lupus erythematosus (SLE) and to present the measurement properties of US in different elementary lesions and pathologies.

Methods: A systematic literature search of PubMed, Embase, and the Cochrane Library was performed. Original articles were included that were published in English between August 1, 2014, and December 31, 2018, reporting US, Doppler, synovitis, joint effusion, bone erosion, tenosynovitis, and enthesitis in patients with SLE.

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Objective: To develop ultrasound (US) definitions and a US novel scoring system for major salivary gland (SG) lesions in patients with primary Sjögren's syndrome (pSS) and to test their intrareader and inter-reader reliability using US video clips.

Methods: Twenty-five rheumatologists were subjected to a three-round, web-based Delphi process in order to agree on (1) definitions and scanning procedure of salivary gland ultrasonography (SGUS): parotid, submandibular and sublingual glands (PG, SMG and SLG); (2) definitions for the elementary SGUS lesions in patients with Sjögren's syndrome; (3) scoring system for grading changes. The experts rated the statements on a 1-5 Likert scale.

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Objective: To evaluate the level of agreement on ultrasonographic (US) lesions among highly experienced sonographers as well as the intraobserver and interobserver reliability of inflammatory and structural US lesions in patients with osteoarthritis (OA) of the foot.

Methods: After a systematic literature review, a Delphi survey was performed to test definitions of US lesions in OA of the foot, including inflammatory lesions (ie, synovial hypertrophy [SH], joint effusion [JE], power Doppler signal [PD]), and structural abnormalities (ie, cartilage damage [CD] and osteophytes). Subsequently, the reliability of US in assessing the aforementioned lesions was tested on static images as well as during a live exercise.

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Objective: The Outcome Measures in Rheumatology (OMERACT) Ultrasound (US) Working Group (WG) operates research activities for the validation of US as an outcome measurement instrument according to the Filter 2.0 framework.

Methods: Original publications on definitions and scoring systems for pathophysiological manifestations and elementary lesions of various rheumatic disorders were reviewed from the onset of the WG research in 2005.

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Article Synopsis
  • The study aimed to evaluate the reliability of ultrasound criteria from OMERACT for identifying normal and vasculitic arteries in patients with giant cell arteritis (GCA) and control subjects.
  • Preliminary and main meetings involved 12 experienced sonographers analyzing temporal and axillary arteries at two time points, revealing varied inter- and intrareader reliability that improved significantly during the main exercise after training.
  • The findings concluded that with proper training and experienced sonographers, OMERACT definitions for detecting signs of vasculitis in GCA are reliable when following standardized procedures and using appropriate ultrasound equipment.
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Article Synopsis
  • The study aimed to define key ultrasound (US) lesions in giant cell arteritis (GCA) and assess the reliability of these definitions through a web-based exercise.
  • A systematic literature review helped identify potential criteria for normal vs. abnormal US findings in large arteries, followed by a Delphi exercise with experts to finalize definitions.
  • Key findings showed that the 'halo' and 'compression' signs were crucial US lesions for GCA, with high reliability among experts confirming these definitions.
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