Amendment of the OMERACT ultrasound definitions of joints’ features in healthy children when using the DOPPLER technique

Abstract

BackgroundRecently preliminary ultrasonography (US) definitions, in B mode, for normal components of pediatric joints have been developed by the OMERACT US group. The aim of the current study was to include Doppler findings in the evaluation and definition of normal joint features that can be visualized in healthy children at different age groups.MethodsA multistep approach was used. Firstly, new additional definitions of joint components were proposed during an expert meeting. In the second step, these definitions, along with the preliminary B-mode-US definitions, were tested for feasibility in an exercise in healthy children at different age groups. In the last step, a larger panel of US experts were invited to join a web-based consensus process in order to approve the developed definitions using the Delphi methodology. A Likert scale of 1–5 was used to assess agreement.ResultsPhysiological vascularity and fat pad tissue were identified and tested as two additional joint components in healthy children. Since physiological vascularity changes over the time in the growing skeleton, the final definition of Doppler findings comprised separate statements instead of a single full definition. A total of seven statements was developed and included in a written Delphi questionnaire to define and validate the new components. The final definitions for fat pad and physiological vascularity agreed by the group of experts reached 92.9% and 100% agreement respectively in a web survey.ConclusionThe inclusion of these two additional joints components which are linked to detection of Doppler signal in pediatric healthy joints will improve the identification of abnormalities in children with joint pathologies.Electronic supplementary materialThe online version of this article (10.1186/s12969-018-0240-2) contains supplementary material, which is available to authorized users.

Novel Ultrasound Image Acquisition Protocol and Scoring System for the Pediatric Knee

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Gelenksonografie im Treat-to-Target-Konzept bei der juvenilen idiopathischen Arthritis

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What is the real role of ultrasound in the management of juvenile idiopathic arthritis?

“…A systematic standardised examination method was proposed, and an atlas of images of normal joint appearance at different ages has accordingly been created. Subsequently, the Outcome Measures in Rheumatology (OMERACT) task force for paediatric US described the vascularity in normal joints and amended the B-mode definition when using Doppler technique 4. Importantly, physiological vascularity can be detected by power Doppler in healthy children at any age during growth.…”