Juvenile arthritisComparison of Clinical and Ultrasonographic Evaluations for Peripheral Synovitis in Juvenile Idiopathic Arthritis
Section snippets
Patients
Consecutive patients referred to our pediatric rheumatology center were included prospectively if they met diagnostic criteria for JIA in the Durban classification (6) and if US was performed within 3 days after a physical assessment. Standardized forms were used to collect the following data: sex, age at onset, disease duration, International League of Associations for Rheumatology category, pain intensity as evaluated on a visual analog scale by the patient and/or parents, current treatment,
Study Participants
We included 31 consecutive JIA patients with available physical and US assessments. There were 17 females and 14 males. Mean disease duration was 3.6 ± 3.3 years. Oligoarticular and enthesitis-related JIA predominated (Table 1). The treatment included methotrexate in 47% of patients, biological agents in 8.7%, and glucocorticoids in 10%.
The control group comprised 41 healthy children, including 20 females and 21 males aged 2.7 to 15.8 years. None of the controls had joint swelling, pain on
Discussion
JIA is a heterogeneous group of diseases defined as persistent arthritis for more than 6 weeks with an onset before 16 years and no other identifiable cause. Several JIA subtypes are distinguished based on symptoms in the first 6 months. The prognosis varies across subtypes and according to the number of affected joints (12). Therefore, the clinical joint evaluation is of prime importance for diagnosing JIA, monitoring disease activity, and predicting the outcome. The most common sites of
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2018, Egyptian Journal of Radiology and Nuclear MedicineCitation Excerpt :Haslam et al. [16] also reported a discrepancy between clinical and US examination in oligoarticular JIA, with subclinical synovitis, especially in the hands and feet small joints. Similar findings were also detected in the work of Breton et al. [17] Accordingly the use of US in JIA children may allow earlier diagnosis of joint synovitis or detect extension of arthritis to clinically normal joints. Although treating clinically normal joints based on Doppler findings only may carry the risk of overtreatment, still combining clinical and Doppler findings may be beneficial.
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