Studies that reported any information on reliability for detection of synovitis by ultrasound in adults with rheumatoid arthritis were eligible for inclusion.
Included studies used binary, categorical (0 to 3 categories) or quantitative scoring system for synovitis and reported on interobserver and or intraobserver reliability. Joints examined included the metacarpophalangeal (MCP), proximal interphalangeal (PIP), distal interphalangeal (DIP), metatarsophalangeal (MTP), wrist, shoulder, elbow, hip, knee, ankle and foot. Observers were either rheumatologists or radiologists and were experienced in musculoskeletal ultrasonography (except one that included rheumatology fellows with limited ultrasonographic experience). Ultrasonographic mode included B-mode, power Doppler, 3-D power Doppler, and contrast power Doppler alone or in combination. Ultrasonographic data were image acquisition, still images or both. The time to retest for studies that assessed intra-observer reliability ranged from 30 minutes to one year. The number of observers assessed for inter-observer reliability studies ranged from two to 23. Patients had typical active rheumatoid arthritis in 28 joints with Disease Activity Scores that ranged from 4.9 to 5.9.
The authors did not state how`many reviewers assessed studies for inclusion.