Compression-strain US elastography does not accurately detect active myositis in children with juvenile idiopathic inflammatory myopathy and cannot replace MRI as the imaging standard for detecting myositis in these children. The association between abnormal US elastography and increased muscle echogenicity suggests that elastography is capable of detecting muscle derangement in patients with myositis; however further studies are required to determine the clinical significance of these findings.
The past two decades have brought immense satisfaction to pediatric rheumatologists and families of children with rheumatologic diseases. We have been able to better classify, recognize, and diagnose rheumatologic diseases, but most importantly, the discovery of biologic therapies and their efficacy and relative safety in treating multiple rheumatologic conditions, improving quality of life for the patients we care for. We will review the advances of the past two decades and discuss potential areas for new discoveries.
The continuous advance in the search for the cause and pathogenesis of the autoinflammatory syndromes, as well as reports of the efficacy of specific inflammation-mediator suppressors, has changed the way these syndromes are approached and treated; both the acute and long-term treatment of these diseases has improved significantly. Etiologic and pathophysiologic manipulation is and will be the future for controlling, even curing, this new and rare set of diseases.
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