Ultrasound versus physical examination in predicting disease flare in children with juvenile idiopathic arthritis: a systematic literature review and qualitative synthesis

Lucia, Orazio De; Giani, Teresa; Caporali, Roberto; Cimaz, Rolando

doi:10.11152/mu-3303

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…Ultrasound has been found to be a valid tool for the detection of synovitis in JIA, some authors have found a prevalence of low to moderate subclinical synovitis by ultrasound, particularly in small joints. However, the prognostic significance of such subclinical synovitis remains to be determined [4,11,12].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Subclinical Activity by Ultrasound Examination in Mexican Children with Juvenile Idiopathic Arthritis in Remission

2022

JCRR

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Background: Juvenile Idiopathic Arthritis (JIA) is a chronic disease that affects 0.6 - 1.9 /1,000 children. Persistent joint inflammation conditions cartilage damage and erosions. Recent studies have shown that clinical examination significantly underestimates joint inflammation, with ultrasound having a higher sensitivity. The aim of this study was determined the prevalence of subclinical synovitis by musculoskeletal ultrasound in Mexican children with JIA in remission. Methods: Cross-sectional study, patients with JIA in clinical remission based on the Wallace criteria were included, with and without pharmacological treatment, we also included a control group of healthy children. The evaluation was performed by a certified Rheumatologist in Pediatric Musculoskeletal Ultrasound by EULAR. Joints clinically examined were also evaluated following the standard guidelines. Results: A total of 37 JIA patients with clinical remission and 33 healthy children were evaluated (1260 joints scanned), subclinical activity was detected in 15/37 (40.5%) patients and none of healthy children; 14 patients were still on treatment (93.3%). The subclinical activity was detected by gray scale in 22/1260 (1.7%) or by power Doppler (PD) in 15/1260 (1.1%) joints, the knee was involved in 13/22 (59%) joints. The subtype mainly affected was the rheumatoid factor-positive (FR) polyarticular (33.3%), erosions were detected in three patients (8%). In the knee, we observed slight distention of the supra patellar recess, evidenced in 19/33 healthy children (57.5%), predominantly among children aged 4 to 8 years. When comparing the groups with or without subclinical synovitis, no statistically significant differences were found with regard to age, evolution time or acute phase reactants. Conclusions: Subclinical synovitis was detected in 40.5% of the patients in clinical remission using gray scale or by power Doppler, mainly on those who were still on treatment. The most affected subtype was the rheumatoid factor-positive polyarticular, the knees were the most frequent involved. In the healthy children, a slight distention of the supra patellar recess was observed in almost half of cases.

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Section: Introductionmentioning

confidence: 99%

Prevalence of Subclinical Activity by Ultrasound Examination in Mexican Children with Juvenile Idiopathic Arthritis in Remission

2022

JCRR

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The role of ultrasonography in assessing remission in juvenile idiopathic arthritis: a systematic review

et al. 2023

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Medikamentöse Absetzstrategien in der Kinderrheumatologie

Minden

2024

Arthritis und Rheuma

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ZUSAMMENFASSUNGDie Prognose der juvenilen idiopathischen Arthritis (JIA) hat sich durch die Anwendung neuer Therapiestrategien und moderner Antirheumatika erheblich verbessert. Viele Patienten erreichen heute eine langanhaltende Remission, was die Frage nach einem möglichen Absetzen der Therapie aufwirft. In der klinischen Praxis variiert das Vorgehen beim Absetzen von krankheitsmodifizierenden Antirheumatika erheblich. Dabei spielen Faktoren wie die spezifische Form der JIA, das initiale Therapieansprechen, das Vorhandensein von Krankheitsschäden sowie die Präferenzen von Patienten und Familien eine Rolle. Dieser Übersichtsbeitrag stellt die aktuelle Evidenz zur Therapiedeeskalation bei der JIA vor. Es werden relevante Studien und Prädiktoren für ein erfolgreiches Absetzen der Therapie diskutiert. Zudem werden Strategien zur Erreichung einer medikamentenfreien Remission erörtert, einschließlich der potenziellen Rolle von Biomarkern und bildgebenden Verfahren. Basierend auf den vorhandenen, wenngleich noch begrenzten, Erkenntnissen werden Hinweise für den klinischen Alltag formuliert.

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Ultrasound versus physical examination in predicting disease flare in children with juvenile idiopathic arthritis: a systematic literature review and qualitative synthesis

Cited by 3 publications

References 31 publications

Prevalence of Subclinical Activity by Ultrasound Examination in Mexican Children with Juvenile Idiopathic Arthritis in Remission

Prevalence of Subclinical Activity by Ultrasound Examination in Mexican Children with Juvenile Idiopathic Arthritis in Remission

The role of ultrasonography in assessing remission in juvenile idiopathic arthritis: a systematic review

Medikamentöse Absetzstrategien in der Kinderrheumatologie

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