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Potential of ultrasonography for epidemiological study of work-related wrist tenosynovitis
  1. F S Violante1,
  2. R Bonfiglioli1,
  3. F Graziosi1,
  4. A Caso3,
  5. L Isolani4,
  6. C Fiorentini2,
  7. S Mattioli1
  1. 1Alma Mater Studiorum, University of Bologna, Italy
  2. 2Occupational Health Unit, Policlinico Sant’Orsola-Malpighi, Bologna, Italy
  3. 3UO Prevenzione e Sicurezza Ambienti di Lavoro USL Forlì, Italy
  4. 4SPSAL, ASUR Regionale Marche Macerata, Italy
  1. Correspondence to:
 Dr C Fiorentini
 Unità Operativa di Medicina del Lavoro, Policlinico S Orsola-Malpighi, Azienda Ospedaliera di Bologna, Via P Palagi, 9-40138 Bologna, Italy; cristiana.fiorentini{at}unibo.it

Abstract

Objective: To explore the possible role of ultrasonography in case definitions for epidemiological studies of work-related wrist tenosynovitis.

Methods: Clinical and ultrasonography (7.5 MHz linear probe) data systematically collected from meat workers (n = 128) with biomechanical exposure characterisation were analysed. The diagnostic accuracy of different combinations of potentially relevant ultrasonography findings (nonhomogeneity, thickening and anechoic halo) was evaluated using symptomatology as a reference standard. The concordance between ultrasonography findings and symptoms was then analysed.

Results: Analysis of wrist biomechanical exposure was suggestive of increased prevalence of musculoskeletal disorders. Using symptoms as a reference standard, each of the three ultrasonography findings (and their combinations) showed good specificity (⩾85%) accompanied by low sensitivity (<60%); the positive likelihood ratio for at least two findings was 4.1. κ Values (95% confidence intervals) between symptoms and different sets of ultrasonography findings were as follows: for non-homogeneity, κ = 0.31 (0.19 to 0.43); at least one finding, κ = 0.28 (0.16 to 0.40); at least two findings, κ = 0.32 (0.20 to 0.44); all p<0.01.

Conclusion: The use of ultrasonography in symptomatic subjects could contribute to a more specific epidemiological case definition of wrist tenosynovitis. The results of this study could help orient future research in this direction.

  • BMI, body mass index

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Footnotes

  • Published Online First 14 September 2006

  • Competing interests: None declared.