Clinical assessment and core outcome variables are poor predictors of hip arthritis diagnosed by MRI in juvenile idiopathic arthritis

Nistala, Kiran; Babar, Judith; Johnson, Karl; Campbell-Stokes, Priscilla; Foster, K.; Ryder, Clive; McDonagh, Janet E.

doi:10.1093/rheumatology/kel401

Cited by 48 publications

(32 citation statements)

References 14 publications

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“…MRI is the only tool that has the ability to simultaneously assess all features of synovial disease and is exquisitely suited for the evaluation of disease activity in the temporomandibular, hip, sacroiliac, and vertebral joints [52–55] (Fig. 3).…”

Section: Diagnosismentioning

confidence: 99%

Juvenile Idiopathic Arthritis: Diagnosis and Treatment

et al. 2016

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Juvenile idiopathic arthritis is a broad term that describes a clinically heterogeneous group of arthritides of unknown cause, which begin before 16 years of age. This term encompasses several disease categories, each of which has distinct presentation, clinical manifestations, and, presumably, genetic background and etiopathogenesis. Although none of the available drugs has curative potential, prognosis has greatly improved as a result of substantial progresses in disease management. The most important new development has been the introduction of the biologic medications, which constitute a valuable treatment option for patients who are resistant to conventional antirheumatic agents. Further insights into the disease pathogenesis and treatment will be provided by the continuous advances in understanding of the mechanisms related to the immune response and inflammatory process, and by the development of new drugs that are capable of selectively inhibiting single molecules or pathways.

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Section: Diagnosismentioning

confidence: 99%

Juvenile Idiopathic Arthritis: Diagnosis and Treatment

et al. 2016

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“…Nistala et al [6] documented a sensitivity of 25.7% for clinical assessments in the detection of active disease in juvenile idiopathic arthritis in the hip joint. MRI was much more sensitive in detecting active arthritis in the hip when compared with both clinical and laboratory assessments.…”

Section: Kim Et Almentioning

confidence: 99%

T2 Relaxation Time Changes in Distal Femoral Articular Cartilage in Children With Juvenile Idiopathic Arthritis: A 3-Year Longitudinal Study

Kim

Laor

Graham

et al. 2010

American Journal of Roentgenology

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“…With new treatments, the induction of sustained remission is possible for an increasing percentage of children but cannot always be reliably demonstrated on clinical examination alone (7)(8)(9)(10). In addition, the exact determination of remission status is important for the decision to taper medication, thereby preventing side effects from long-term use.…”

Section: Introductionmentioning

confidence: 99%

Definitions for the Sonographic Features of Joints in Healthy Children

Roth

Jousse‐Joulin

Magni‐Manzoni

et al. 2014

Arthritis Care & Research

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Objective. Musculoskeletal ultrasonography (US) has potential in the assessment of disease activity and structural damage in childhood arthritides. In order to assess pathology, the US characteristics of joints in healthy children need to be defined first. The aim of this study was to develop definitions for the various components of the normal pediatric joint. Methods. The definitions were developed by an expert group and applicability was assessed on a collection of standardized scans of the knee and ankle joints by scoring the scans on a Likert scale. The definitions were then modified and applicability was reassessed before sending the definitions for approval to a larger panel of experts. A final scoring on stored images of all relevant joints at different ages followed. Results. Five definitions were developed addressing the articular bone, cartilage, joint capsule, epiphyseal ossification center, and synovial membrane. In total, 224 US images of knees and ankles were acquired, of which 172 were selected for scoring. An agreement of >80% was not met for any of the definitions, but after modifications, 81-97% agreement was reached. This version of the definitions was approved by 15 US experts. In the final validation exercise, all definitions reached an agreement of >80% for the shoulder, elbow, wrist, metacarpophalangeal hip, knee, ankle and metatarsophalangeal joint. Conclusion. US definitions for the normal pediatric joint were successfully developed through a Delphi process and validated in a practical exercise. These results provide the basis to develop definitions for pathology and to support the standardized use of US in pediatric rheumatology.

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Clinical assessment and core outcome variables are poor predictors of hip arthritis diagnosed by MRI in juvenile idiopathic arthritis

Abstract: The association between the clinician's assessment, core outcome variables and MRI findings in this study was limited. This indicates that clinical and laboratory findings are inadequate diagnostic tools for the assessment of hip arthritis when compared with MRI as the gold standard.

Cited by 48 publications

References 14 publications

Juvenile Idiopathic Arthritis: Diagnosis and Treatment

Juvenile Idiopathic Arthritis: Diagnosis and Treatment

T2 Relaxation Time Changes in Distal Femoral Articular Cartilage in Children With Juvenile Idiopathic Arthritis: A 3-Year Longitudinal Study

Definitions for the Sonographic Features of Joints in Healthy Children

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