Article
Echogenicity of palmar Dupuytren nodules is not a predictor of disease progression in terms of increase in nodule size
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Published: | February 6, 2020 |
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Objectives/Interrogation: Activity of Dupuytren nodules may be measured with ultrasound. It has been suggested that early nodules appear hypo-echogenic, whereas older nodules appear iso- to hyper-echogenic. The aim of this study was to analyse whether echogenicity of Dupuytren nodules can be used to predict disease progression in terms of increase in nodule size and to calculate the reliability of measurement of echogenicity.
Methods: Sonographic assessment of a single Dupuytren nodule was performed in 91 patients participating in an existing longitudinal cohort at our hospital. Echogenicity of nodules was matched to growth, measured with physical examination, one year later, using linear regression analysis. A sensitivity analysis was performed, using data of a year prior to ultrasound.
For the calculation of reliability, two observers scored the ultrasound images for echogenicity. The first observer scored the images twice and the second observer scored the images once. The inter- and intra-observer reliability were calculated using the intra-class correlation coefficient (ICC).
Results and Conclusions: Hypo-echogenicity did not predict progression in terms of increase in nodule size one year later (Beta=-0.019, P=0.748). Sensitivity analysis showed that hypo-echogenic nodules were more likely to have grown in the past year (Beta=0.173, P=0.011). However, these results were most likely influenced by nodules that had emerged in the year prior to ultrasound.
The reliability of measurement of echogenicity of Dupuytren nodules, measured by a single observer, was excellent (ICC=0.996, 95% CI: 0.993-0.998). The reliability of measurement of echogenicity of Dupuytren nodules by different observers was less satisfying, with an ICC of 0.688 (95% CI: 0.329-0.977).
Further research is necessary to define the relation between echogenicity of Dupuytren nodules and disease activity. When measuring echogenicity, the use of a single observer leads to more consistent results.