Consensus-based identification of factors related to false-positives in ultrasound scanning of synovitis and tenosynovitis

Kei Ikeda, Akihiro Narita, Michihiro Ogasawara, Shigeru Ohno, Yutaka Kawahito, Atsushi Kawakami, Hiromu Ito, Isao Matsushita, Takeshi Suzuki, Kenta Misaki, Takehisa Ogura, Tamotsu Kamishima, Yohei Seto, Ryuichi Nakahara, Atsushi Kaneko, Takayuki Nakamura, Mihoko Henmi, Jun Fukae, Keiichiro Nishida, Takayuki SumidaTakao Koike

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Introduction: We aimed to identify causes of false-positives in ultrasound scanning of synovial/tenosynovial/bursal inflammation and provide corresponding imaging examples.Methods: We first performed systematic literature review to identify previously reported causes of false-positives. We next determined causes of false-positives and corresponding example images for educational material through Delphi exercises and discussion by 15 experts who were an instructor and/or a lecturer in the 2013 advanced course for musculoskeletal ultrasound organized by Japan College of Rheumatology Committee for the Standardization of Musculoskeletal Ultrasonography.Results: Systematic literature review identified 11 articles relevant to sonographic false-positives of synovial/tenosynovial inflammation. Based on these studies, 21 candidate causes of false-positives were identified in the consensus meeting. Of these items, 11 achieved a predefined consensus (≥ 80%) in Delphi exercise and were classified as follows: (I) Gray-scale assessment [(A) non-specific synovial findings and (B) normal anatomical structures which can mimic synovial lesions due to either their low echogenicity or anisotropy]; (II) Doppler assessment [(A) Intra-articular normal vessels and (B) reverberation)]. Twenty-four corresponding examples with 49 still and 23 video images also achieved consensus.Conclusions: Our study provides a set of representative images that can help sonographers to understand false-positives in ultrasound scanning of synovitis and tenosynovitis.

Original languageEnglish
Pages (from-to)9-14
Number of pages6
JournalModern Rheumatology
Issue number1
Publication statusPublished - Jan 2 2016


  • False-positive
  • Pitfall
  • Synovitis
  • Tenosynovitis
  • Ultrasound

ASJC Scopus subject areas

  • General Medicine


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