TY - JOUR
T1 - A global OMERACT ultrasound joint damage scoring system (GLODS) in rheumatoid arthritis
AU - Mandl, Peter
AU - Gessl, Irina
AU - Kun, Lyubomyra
AU - Filippou, Georgios
AU - Kortekaas, Marion
AU - Pineda, Carlos
AU - Terslev, Lene
AU - Möller, Ingrid
AU - Backhaus, Marina
AU - Bong, David
AU - Cipolletta, Edoardo
AU - Collado, Paz
AU - Dejaco, Christian
AU - Delle Sedie, Andrea
AU - Duftner, Christina
AU - Hammer, Hilde Berner
AU - Iagnocco, Annamaria
AU - Karim, Zunaid
AU - Keen, Helen
AU - Naredo, Esperanza
AU - Pellegrino, Greta
AU - Schmidt, Wolfgang
AU - Sirotti, Silvia
AU - Szkudlarek, Marcin
AU - Tamborrini, Giorgio
AU - Wong, Priscilla
AU - Filippucci, Emilio
AU - Balint, Peter V.
AU - D’Agostino, Maria Antonietta
AU - OMERACT Ultrasound Working Group
N1 - Publisher Copyright:
© 2026 The Author(s). Published by Elsevier B.V. on behalf of European Alliance of Associations for Rheumatology (EULAR). This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/
PY - 2026
Y1 - 2026
N2 - Objectives: This study aimed to develop consensual definitions and semiquantitative scoring for structural damage on ultrasound and to test the reliability of individual components of a global Outcome Measures in Rheumatology ultrasound joint damage score (GLODS) in rheumatoid arthritis (RA). Methods: A Delphi survey including statements on normal ultrasound appearance of joint features, scanning technique, new definitions, and scoring systems for 3 components of structural damage (bone erosions, cartilage change, and joint malalignment) was circulated among task force members. After agreement (≥75% of grades 4-5 on a 1-5 Likert scale) was achieved on the statements, datasets of ultrasound images representing various grades of the above-mentioned structural damage components were created and used in 2 web-based exercises. Finally, the metacarpophalangeal joints 1 to 5 of 7 patients with RA were scanned with ultrasound, twice on the same day by 7 task force members for detecting and scoring the 3 components using the consensus-based semiquantitative GLODS. Intraobserver and interobserver reliability of the new scoring system was measured by weighted kappa. Results: Agreement on a total of 9 statements was reached in 4 Delphi rounds. Intraobserver and interobserver reliability for the individual components ranged from good to excellent in both the web-based (0.72-0.97) and the live exercises (0.68-0.89). Intraobserver and interobserver reliability of the total GLODS was shown to be excellent (0.92) and good (0.69), respectively. Conclusions: Ultrasound is a reliable tool for evaluating bone erosions, cartilage change, and joint malalignment in the hand joints of patients with RA. These features can be reliably integrated into a global ultrasound score.
AB - Objectives: This study aimed to develop consensual definitions and semiquantitative scoring for structural damage on ultrasound and to test the reliability of individual components of a global Outcome Measures in Rheumatology ultrasound joint damage score (GLODS) in rheumatoid arthritis (RA). Methods: A Delphi survey including statements on normal ultrasound appearance of joint features, scanning technique, new definitions, and scoring systems for 3 components of structural damage (bone erosions, cartilage change, and joint malalignment) was circulated among task force members. After agreement (≥75% of grades 4-5 on a 1-5 Likert scale) was achieved on the statements, datasets of ultrasound images representing various grades of the above-mentioned structural damage components were created and used in 2 web-based exercises. Finally, the metacarpophalangeal joints 1 to 5 of 7 patients with RA were scanned with ultrasound, twice on the same day by 7 task force members for detecting and scoring the 3 components using the consensus-based semiquantitative GLODS. Intraobserver and interobserver reliability of the new scoring system was measured by weighted kappa. Results: Agreement on a total of 9 statements was reached in 4 Delphi rounds. Intraobserver and interobserver reliability for the individual components ranged from good to excellent in both the web-based (0.72-0.97) and the live exercises (0.68-0.89). Intraobserver and interobserver reliability of the total GLODS was shown to be excellent (0.92) and good (0.69), respectively. Conclusions: Ultrasound is a reliable tool for evaluating bone erosions, cartilage change, and joint malalignment in the hand joints of patients with RA. These features can be reliably integrated into a global ultrasound score.
U2 - 10.1016/j.ard.2026.07.004
DO - 10.1016/j.ard.2026.07.004
M3 - Journal article
C2 - 42542402
AN - SCOPUS:105046114475
SN - 0003-4967
JO - Annals of the Rheumatic Diseases
JF - Annals of the Rheumatic Diseases
ER -