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Reliability of OMERACT ultrasound elementary lesions in gout: results from a multicenter exercise

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Abstract

The aim of this study was to evaluate the reliability of the outcome measures in rheumatology (OMERACT) definitions for ultrasound (US) elementary lesions in gout through an image reading exercise. Images from patients with gout (static images and videos) were collected. As an initial step, we carried out a image reading exercise within the experts of the Pan-American League of Associations for Rheumatology (PANLAR) US Study Group (n = 16). The following step consisted in a web-based exercise with the participation of larger number of sonographers (n = 63) from different centers. Images were rated evaluating the presence/absence of any US elementary lesion. Inter- and intra-reader reliabilities were analyzed using kappa coefficients. Participants were stratified according to their level of experience. In the first exercise, inter-reader kappa values were 0.45 for aggregates, 0.57 for tophus, 0.69 for erosions, and 0.90 for double contour (DC). Intra-reader kappa values were 0.86, 0.76, 0.80, and 0.90, respectively. The web-based exercise showed inter-reader kappa values for aggregates, tophus, erosions, and DC of 0.42, 0.49, 0.69, and 0.79, respectively. The intra-reader kappa values were 0.62, 0.69, 0.77, and 0.85, respectively. Reliability was not influenced by the sonographer’s level of experience. The reliability of the new OMERACT US definitions for elementary lesions in gout ranged from moderate to excellent, depending on the type of lesion.

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References

  1. Wortmann RL (2002) Gout and hyperuricemia. Curr Opin Rheumatol 14:281–286

    Article  PubMed  Google Scholar 

  2. Eason A, House ME, Vincent Z et al (2016) Factors associated with change in radiographic damage scores in gout: a prospective observational study. Ann Rheum Dis 75:2075–2079

    Article  PubMed  Google Scholar 

  3. Perez-Ruiz F, Martínez-Indart L, Carmona L et al (2014) Tophaceous gout and high level of hyperuricaemia are both associated with increased risk of mortality in patients with gout. Ann Rheum Dis 73:177–182

    Article  CAS  PubMed  Google Scholar 

  4. Pascual E, Sivera F, Andrés M (2011) Synovial fluid analysis for crystals. Curr Opin Rheumatol 23:161–169

    PubMed  Google Scholar 

  5. Swan A, Amer H, Dieppe P (2002) The value of synovial fluid assays in the diagnosis of joint disease: a literature survey. Ann Rheum Dis 61:493–498

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Dalbeth N, Stamp L (2014) Hyperuricaemia and gout: time for a new staging system? Ann Rheum Dis 73:1598–1600

    Article  PubMed  Google Scholar 

  7. Ruta S, Reginato AM, Pineda C, Gutierrez M, Pan-American League Against Rheumatisms (PANLAR) Ultrasound Study Group (2015) General applications of ultrasound in rheumatology: why we need it in our daily practice. J Clin Rheumatol 21:133–143

    Article  PubMed  Google Scholar 

  8. Neogi T, Jansen TL, Dalbeth N et al (2015) Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 74:1789–1798

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Lee YH, Song GG (2018) Diagnostic accuracy of ultrasound in patients with gout: a meta-analysis. Semin Arthritis Rheum 47:703–709

    Article  PubMed  Google Scholar 

  10. Mathieu S, Pereira B, Couderc M et al (2013) Usefulness of ultrasonography in the diagnosis of gout: a meta-analysis. Ann Rheum Dis 72:e23

    Article  CAS  PubMed  Google Scholar 

  11. Gutierrez M, Schmidt WA, Thiele RG et al (2015) OMERACT Ultrasound Gout Task Force group. International consensus for ultrasound lesions in gout: results of Delphi process and web-reliability exercise. Rheumatology 54:1797–1805

    Article  PubMed  Google Scholar 

  12. Terslev L, Gutierrez M, Christensen R et al (2015) OMERACT US Gout Task Force. Assessing elementary lesions in gout by ultrasound: results of an OMERACT patient-based agreement and reliability exercise. J Rheumatol 42:2149–2154

    Article  CAS  PubMed  Google Scholar 

  13. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174

    Article  CAS  Google Scholar 

  14. Light RJ (1971) Measures of response agreement for qualitative data: some generalizations and alternatives. Psychol Bull 76:365–377

    Article  Google Scholar 

  15. Byrt T, Bishop J, Carlin JB (1993) Bias, prevalence and kappa. J Clin Epidemiol 46:423–429

    Article  CAS  Google Scholar 

  16. Chowalloor PV, Keen HI (2013) A systematic review of ultrasonography in gout and asymptomatic hyperuricemia. Ann Rheum Dis 72:638–645

    Article  PubMed  Google Scholar 

  17. Filippucci E, Riveros MG, Georgescu D et al (2009) Hyaline cartilage involvement in patients with gout and calcium pyrophosphate deposition disease. An ultrasound study. Osteoarthr Cartil 17:178–181

    Article  CAS  PubMed  Google Scholar 

  18. Naredo E, Uson J, Jiménez-Palop M et al (2014) Ultrasound-detected musculoskeletal urate crystal deposition: which joints and what findings should be assessed for diagnosing gout? Ann Rheum Dis 73:1522–1528

    Article  PubMed  Google Scholar 

Download references

Funding

This study received no funding.

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Authors and Affiliations

  1. Rheumatology Unit, Instituto de Rehabilitación Psicofísica, Echeverria 955, Buenos Aires, C1428DQG, Argentina

    Tomas Cazenave, Victoria Martire & Marcos Gabriel Rosemffet

  2. Division of Rheumatology, The Warren Alpert School of Medicine at Brown University, Providence, USA

    Anthony M. Reginato

  3. Division of Musculoskeletal and Rheumatic Diseases Instituto Nacional de Rehabilitacion, Mexico City, Mexico

    Marwin Gutierrez, Carlos Pineda, Cristina Hernandez-Diaz & Lucio Ventura-Rios

  4. Rheumatology Section, Hospital Dr. Hector Cura, Olavarria, Argentina

    Christian Alfredo Waimann & Maria Florencia Marengo

  5. Rheumatology Section, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Javier Eduardo Rosa, Santiago Ruta & Josefina Marin

  6. Escuela de Ecografia ECOSERMEDIC, Lima, Peru

    Oscar Sedano-Santiago

  7. Instituto Reumatológico Strusberg, Cordoba, Argentina

    Ana Maria Bertoli

  8. Rheumatology Department, Hospital Nacional de Clínicas, Cordoba, Argentina

    Marcelo Audisio & Guillermo Enrique Py

  9. Medicine School, Universidad de Los Andes-Rheumatology Unit-IAHULA, Merida, Venezuela

    Maritza Quintero

  10. Hospital Universitario La Paz, Madrid, Spain

    Eugenio De Miguel, Diana Peiteado & Irene Monjo Henry

  11. Reumatología Integral Clinic, Monterrey, Mexico

    Ana Laura Alvarez-del-Castillo-Araujo

  12. Rheumatology Department, Mayo Clinic, Jacksonville, FL, USA

    Andy Abril

  13. Rheumatology Department, Hospital Nacional Arzobispo Loayza, Lima, Peru

    Eliana Natalí Ayala-Ledesma

  14. Rheumatology Department, Hospital San Juan de Lurigancho, Lima, Peru

    Edith Alarcon-Isidro

  15. Rheumatology Clinic, Organización Medica de Investigación, Buenos Aires, Argentina

    Maria Lida Santiago & Patricio Tate

  16. Rheumatology Department, Hospital General de Agudos de La Plata, Buenos Aires, Argentina

    Mariana Alejandra Pera

  17. Rheumatology Unit, Hospital Municipal “Dr. Leónidas Lucero”, Bahia Blanca, Argentina

    Cecilia Urquiola, Gustavo Rodriguez Gil & Mara Guinsburg

  18. Rheumatology Unit, Hospital Universitario San Jorge, Pereira, Colombia

    Lina Maria Saldarriaga Rivera

  19. Rheumatology Department, Hospital Nacional Dos de Mayo, Lima, Peru

    Cesar Cefferino

  20. Rheumatology Unit, Hospital Julio Mendez, Buenos Aires, Argentina

    Mariana Benegas

  21. Rheumatology Unit, Hospital Universitario Fundación Santa Fe, Bogota, Colombia

    Mario Enrique Diaz Cortes

  22. Rheumatology Clinic Moreno, Formosa, Argentina

    Maximiliano Bravo & Erika Roxana Catay

  23. Rheumatology Clinic Centro Integral de Alta Complejidad, Salta, Argentina

    Natalia Anahi Estrella

  24. Rheumatology Unit, Hospital Felix Bulnes Cerda, Santiago, Chile

    Roser Areny Micas

  25. Rheumatology Department, Hospital San Juan de Dios, Santiago, Chile

    Jorge Saavedra Muñoz

  26. Rheumatology Unit, Centro Clínico la Isabelica, Valencia, Venezuela

    Rodolfo del Carmen Arape Toyo

  27. Rheumatology Section, Instituto de Cardiología, Santiago del Estero, Argentina

    Maria Soledad Gálvez Elkin

  28. Rheumatology Unit, Centro Medico Privado, Tucuman, Argentina

    Walter Javier Spindler

  29. Rheumatolgy Section, Hospital Jose Maria Cullen, Santa Fe, Argentina

    Clarisa Sandobal

  30. Rheumatology Department, Hospital Universitário Pedro Ernesto, Rio de Janeiro, Brazil

    Manuella Lima Gomes Ochtrop

  31. Rheumatology Unit, GREMEDA, Artigas, Uruguay

    Ricardo Pavao Ayala

  32. Musculoskeletal Imaging Unit, Centro Rossi, Buenos Aires, Argentina

    Gabriel Hector Aguilar

  33. Rheumatology Unit, YReuma Centro Privado, Barquisimeto, Venezuela

    Yvonne Yona Rengel Colina

  34. Rheumatology Department, Hospital Provincial, Rosario, Argentina

    Carla Antonela Airoldi

  35. Rheumatology Department, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru

    Claudia Selene Mora-Trujillo & Magaly Alva Linares

  36. Rheumatology Department, Hospital General de Agudos E. Tornu, Buenos Aires, Argentina

    Maria Paula Kohan & Maria Julia Santa Cruz

  37. Rheumatology Unit, Reumatología Diagnostica Especializada, Santa Cruz, Bolivia

    Lorena Evelin Urioste Eguez

  38. Rheumatology Department, Complejo Hospitalario Torrecárdenas, Almeria, Spain

    Concepción Castillo-Gallego

  39. Rheumatology Unit, Hospital Mexico, San Jose, Costa Rica

    Jose Francisco Diaz-Coto

  40. Rheumatology Section, Hospital Anita Elicagaray, Adolfo Gonzales Chaves, Argentina

    Carla Magali Saucedo

  41. Rheumatology Unit, Reumacenter and Essalud, Juliaca, Peru

    Oscar Vega-Hinojosa

  42. Rheumatology Unit, Hospital Bernardino Rivadavia, Buenos Aires, Argentina

    Cristian Jonatan Troitiño & Priscila Maria Marcaida

  43. Rheumatology Unit, Hospital Docente Padre Billini, Santo Domingo, Dominican Republic

    Roberto Muñoz-Louis

  44. Rheumatology Unit, Hospital Nacional Rosales, San Salvador, El Salvador

    Carla Solano

  45. Rheumatology Unit, Clinica Razetti, Barquisimeto, Venezuela

    Felix Reinaldo Fernandez Castillo

  46. Rheumatology Unit, Centro Médico Mitre, Parana, Argentina

    Cesar Enrique Graf

  47. Rheumatology Unit, Hospital Dr. Marcial V. Quiroga, San Juan, Argentina

    David Alejandro Navarta Ortiz

Authors
  1. Tomas Cazenave
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  2. Victoria Martire
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  3. Anthony M. Reginato
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  4. Marwin Gutierrez
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  5. Christian Alfredo Waimann
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  6. Carlos Pineda
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  7. Javier Eduardo Rosa
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  8. Santiago Ruta
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  9. Oscar Sedano-Santiago
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  10. Ana Maria Bertoli
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  11. Marcelo Audisio
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  12. Cristina Hernandez-Diaz
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  13. Lucio Ventura-Rios
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  14. Maritza Quintero
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  15. Eugenio De Miguel
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  16. Ana Laura Alvarez-del-Castillo-Araujo
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  17. Andy Abril
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  18. Eliana Natalí Ayala-Ledesma
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  19. Edith Alarcon-Isidro
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  20. Maria Lida Santiago
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  21. Mariana Alejandra Pera
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  22. Cecilia Urquiola
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  23. Gustavo Rodriguez Gil
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  24. Lina Maria Saldarriaga Rivera
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  25. Cesar Cefferino
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  26. Mariana Benegas
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  27. Mario Enrique Diaz Cortes
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  28. Maximiliano Bravo
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  29. Diana Peiteado
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  30. Natalia Anahi Estrella
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  31. Roser Areny Micas
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  32. Jorge Saavedra Muñoz
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  33. Rodolfo del Carmen Arape Toyo
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  34. Maria Soledad Gálvez Elkin
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  35. Walter Javier Spindler
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  36. Clarisa Sandobal
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  37. Josefina Marin
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  38. Manuella Lima Gomes Ochtrop
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  39. Ricardo Pavao Ayala
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  40. Erika Roxana Catay
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  41. Guillermo Enrique Py
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  42. Gabriel Hector Aguilar
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  43. Yvonne Yona Rengel Colina
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  44. Carla Antonela Airoldi
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  45. Claudia Selene Mora-Trujillo
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  46. Maria Paula Kohan
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  47. Lorena Evelin Urioste Eguez
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  48. Concepción Castillo-Gallego
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  49. Jose Francisco Diaz-Coto
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  50. Patricio Tate
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  51. Carla Magali Saucedo
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  52. Oscar Vega-Hinojosa
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  53. Cristian Jonatan Troitiño
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  54. Maria Florencia Marengo
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  55. Priscila Maria Marcaida
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  56. Irene Monjo Henry
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  57. Roberto Muñoz-Louis
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  58. Carla Solano
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  59. Felix Reinaldo Fernandez Castillo
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  60. Cesar Enrique Graf
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  61. Mara Guinsburg
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  62. Maria Julia Santa Cruz
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  63. David Alejandro Navarta Ortiz
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  64. Magaly Alva Linares
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  65. Marcos Gabriel Rosemffet
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Consortia

Pan-American League of Associations for Rheumatology (PANLAR) Ultrasound Study Group

Corresponding author

Correspondence to Tomas Cazenave.

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Conflict of interest

Tomas Cazenave declares that he has no conflict of interest. Victoria Martire declares that she has no conflict of interest. Anthony M. Reginato declares that he has no conflict of interest. Marwin Gutierrez declares that he has no conflict of interest. Christian Alfredo Waimann declares that he has no conflict of interest. Carlos Pineda declares that he has no conflict of interest. Javier Eduardo Rosa declares that he has no conflict of interest. Santiago Ruta declares that he has no conflict of interest. Oscar Sedano-Santiago declares that he has no conflict of interest. Ana Maria Bertoli declares that she has no conflict of interest. Marcelo Audisio declares that he has no conflict of interest. Cristina Hernandez-Diaz declares that she has no conflict of interest. Lucio Ventura-Rios declares that he has no conflict of interest. Maritza Quintero declares that she has no conflict of interest. Eugenio De Miguel declares that he has no conflict of interest. Ana Laura Alvarez-del-Castillo-Araujo declares that she has no conflict of interest. Andy Abril declares that she has no conflict of interest. Eliana Natalí Ayala-Ledesma declares that she has no conflict of interest. Edith Alarcon-Isidro declares that she has no conflict of interest. Maria Lida Santiago declares that she has no conflict of interest. Mariana Alejandra Pera declares that she has no conflict of interest. Cecilia Urquiola declares that she has no conflict of interest. Gustavo Rodriguez Gil declares that he has no conflict of interest. Lina Maria Saldarriaga Rivera declares that she has no conflict of interest. Cesar Cefferino declares that he has no conflict of interest. Mariana Benegas declares that she has no conflict of interest. Mario Enrique Diaz Cortes declares that he has no conflict of interest. Maximiliano Bravo declares that he has no conflict of interest. Diana Peiteado declares that she has no conflict of interest. Natalia Anahi Estrella declares that she has no conflict of interest. Roser Areny Micas declares that she has no conflict of interest. Jorge Saavedra Muñoz declares that he has no conflict of interest. Rodolfo del Carmen Arape Toyo declares that he has no conflict of interest. Maria Soledad Gálvez Elkin declares that she has no conflict of interest. Walter Javier Spindler declares that he has no conflict of interest. Clarisa Sandobal declares that she has no conflict of interest. Josefina Marin declares that she has no conflict of interest. Manuella Lima Gomes Ochtrop declares that she has no conflict of interest. Ricardo Pavao Ayala declares that he has no conflict of interest. Erika Roxana Catay declares that she has no conflict of interest. Guillermo Enrique Py declares that he has no conflict of interest. Gabriel Hector Aguilar declares that he has no conflict of interest. Yvonne Yona Rengel Colina declares that she has no conflict of interest. Carla Antonela Airoldi declares that she has no conflict of interest. Claudia Selene Mora-Trujillo declares that she has no conflict of interest. Maria Paula Kohan declares that she has no conflict of interest. Lorena Evelin Urioste Eguez declares that she has no conflict of interest. Concepción Castillo-Gallego declares that she has no conflict of interest. Jose Francisco Diaz-Coto declares that he has no conflict of interest. Patricio Tate declares that he has no conflict of interest. Carla Magali Saucedo declares that she has no conflict of interest. Oscar Vega-Hinojosa declares that he has no conflict of interest. Cristian Jonatan Troitiño declares that he has no conflict of interest. Maria Florencia Marengo declares that she has no conflict of interest. Priscila Maria Marcaida declares that she has no conflict of interest. Irene Monjo Henry declares that she has no conflict of interest. Roberto Muñoz-Louis declares that he has no conflict of interest. Carla Solano declares that she has no conflict of interest. Felix Reinaldo Fernandez Castillo declares that he has no conflict of interest. Cesar Enrique Graf declares that he has no conflict of interest. Mara Guinsburg declares that she has no conflict of interest. Maria Julia Santa Cruz declares that she has no conflict of interest. David Alejandro Navarta Ortiz declares that he has no conflict of interest. Magaly Alva Linares declares that she has no conflict of interest. Marcos Gabriel Rosemffet declares that he has no conflict of interest.

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Cazenave, T., Martire, V., Reginato, A.M. et al. Reliability of OMERACT ultrasound elementary lesions in gout: results from a multicenter exercise. Rheumatol Int 39, 707–713 (2019). https://doi.org/10.1007/s00296-018-4220-0

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