Purpose
In the future, it is expected that treatment of Dupuytren disease (DD) may shift toward
control of early disease. Ultrasound might be an accurate method to measure the outcome
of such treatment. The aim of this study was to assess the reliability of sonographic
measurement of palmar nodules.
Methods
Fifty patients with nodules characteristic for early disease were assessed with ultrasound
by 2 observers. Four different aspects of DD nodules were measured in the transversal
and sagittal planes, width, depth, circumference, and area. The intra- and interobserver
reliabilities were calculated using the intraclass correlation coefficient (ICC).
The standard error of measurement (SEM) and the smallest detectable change (SDC) were
also calculated for each aspect.
Results
The intraobserver reliability was good (ICC, 0.724 [0.562–0.833] to 0.886 [0.808–0.934]),
except for width in the sagittal direction (ICC, 0.671 [0.484–0.799]). The interobserver
reliability was moderate (ICC, 0.385 [0.126–0.596] to 0.757 [0.538–0.869]). The intraobserver
ICCs of area were highest (transverse, 0.847 [0.744–0.893]; sagittal, 0.886 [0.808–0.934]).
The SEM and SDC of area were 6.1 and 16.9 mm2 in the transverse and 8.0 and 22.2 mm2 in the sagittal plane.
Conclusions
The intraobserver reliability of sonographic assessment of DD nodules is good. The
measurement of area is the most reliable and is, therefore, recommended for future
studies. However, even single-observer measurements have a clear dispersion, and a
change beyond 16.9 (61%) and 22.2 mm2 (79%) has to be observed in the transverse and sagittal planes, respectively, before
it can be considered as regression or progression.
Clinical relevance
Repeated ultrasonographic measurements in DD should ideally be done by a single observer,
using area of the nodule in the sagittal plane. Change beyond 16.9 (transverse) and
22.2 (sagittal) mm2 can be considered as a real change in nodule size.
Key words
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Article info
Publication history
Published online: March 14, 2020
Accepted:
January 10,
2020
Received:
January 27,
2019
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2020 by the American Society for Surgery of the Hand. All rights reserved.
