Ultrasound Features across Subtypes of Juvenile Idiopathic Arthritis

Abstract

Objective: The aim of this study was to evaluate musculoskeletal ultrasound (MSUS) features across categories of juvenile idiopathic arthritis (JIA). Methods: In this cross-sectional study, all patients were subjected to full history taking, clinical examination including disease assessment parameters and laboratory investigations. In addition, all children were examined by both grayscale (GS) and power Doppler (PD) MSUS images. Results: By MSUS, the number of joints with synovial effusion was 697 of a total 2400 examined joints (29%) and joints with synovial thickening counted 673 (28%). The number of joints with positive PD signals was 446 (18.6%). There was a significant difference among JIA subtypes as regards different MSUS features. Moreover, there was a discrepancy regarding synovial effusion (p = 0.018), hypertrophy scores (p = 0.013), and the total US severity score (p = 0.026). This divergence was attributed to the significant difference between systemic juvenile idiopathic arthritis (SJIA) and other categories. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MSUS in JIA and its subtypes were calculated. Conclusion: MSUS is a highly sensitive method for detecting synovitis, tenosynovitis, and erosive bone disease, and it helps to make proper therapeutic decisions. There was a significant difference among JIA subtypes regarding MSUS features.

The role of ultrasound in pediatric rehabilitation

“…When evaluated together with clinical assessment, synovial thickening, synovial effusion, and power Doppler (active synovitis) presence may support the diagnosis of juvenile idiopathic arthritis. Enthesis can be considered depending on the presence or absence of the entheseal changes of hypoechogenicity, thickening, enthesophyte, erosions, and Doppler signal at enthesis sites including achilles tendon, quadricipital tendon, and distal insertion of the patellar ligament [15,20,21]. To sum up, US provides high-resolution imaging of joints, tendons, ligaments, muscles and nerves in the pediatric population and has numerous applications in the broad field of Pediatric Rehabilitation Medicine.…”

Rheumato at Day 1

“…The importance of repetitive studies to monitor disease progress earned the technique a place in minimizing exposure to ionizing radiation. The team of Mosa, Abdelrahman and El-Bahnasawy [8] shared with us their experience with the various forms of juvenile inflammatory arthritis as a mechanism to avoid radiation effects. 7.…”