OMERACT definition and reliability assessment of chronic ultrasound lesions of the axillary artery in giant cell arteritis

Valentin Sebastian Schäfer, Stavros Chrysidis, Wolfgang A. Schmidt, Christina Duftner, Annamaria Iagnocco, George A. Bruyn, Greta Carrara, Eugenio De Miguel, Andreas P. Diamantopoulos, Berit Dalsgaard Nielsen, Ulrich Fredberg, Wolfgang Hartung, Petra Hanova, Ib Tønder Hansen, Alojzija Hocevar, Aaron Juche, Tanaz A. Kermani, Tove Lorenzen, Pierluigi Macchioni, Marcin MilchertUffe Møller Døhn, Chetan Mukhtyar, Sara Monti, Cristina Ponte, Luca Seitz, Carlo A. Scirè, Lene Terslev, Bhaskar Dasgupta, Helen I. Keen, Carlos Pineda, Christian Dejaco

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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. Results: The final OMERACT ultrasound definition of chronic changes was based on measurement and appearance of the intima-media complex. The overall reliability of the new definition for chronic ultrasound changes in longstanding GCA of the AA was good to excellent with Light's kappa values of 0.79-0.80 for inter-reader reliability and mean Light's-kappa of 0.88 for intra-reader reliability. The mean inter-rater and intra-rater agreements were 86-87% and 92%, respectively. Good reliabilities were observed comparing the vessels with longstanding versus acute GCA with a mean agreement and kappa values of 81% and 0.63, respectively. Conclusion: The new OMERACT ultrasound definition for chronic vasculitis of the AA in GCA revealed a good to excellent inter- and intra-reader reliability in a web-based exercise of experts.

Original languageEnglish
Pages (from-to)951-956
Number of pages6
JournalSeminars in Arthritis and Rheumatism
Issue number4
Early online date18 May 2021
Publication statusPublished - Aug 2021
Externally publishedYes


  • Axillary artery
  • Chronic
  • Definition
  • Giant cell arteritis
  • Ultrasound

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