Detection of Active Disease in Juvenile Idiopathic Arthritis: Sensitivity and Specificity of the Physical Examination vs Ultrasound

Janow, Ginger; Panghaal, Vikash; Trinh, Angela; Badger, David; Levin, Terry L.; Ilowite, Norman T.

doi:10.3899/jrheum.110360

Cited by 69 publications

(34 citation statements)

References 13 publications

(17 reference statements)

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“…This goes in concordance with the study by Ginger et al (2011)[23], which aimed to determine sensitivity and specificity of the physical examination (PE) for identifying synovitis in the knee and ankle joints of children with JIA. Nineteen patients with JIA were referred for US.…”

Section: Discussionsupporting

confidence: 88%

Implementation of musculoskeletal ultrasonography in detection of early juvenile idiopathic arthritis

Darwish

ismael

Ell-Laban

et al. 2016

European Journal of Radiology Open

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AimTo determine whether early clinical, laboratory and musculoskeletal ultrasound (MSUS) characteristics can be used as early detectors of juvenile idiopathic arthritis.Patients and methodsForty (40) patients with juvenile idiopathic arthritis (JIA) diagnosed according to the ILAR criteria [1] and 20 healthy control children. All patients were subjected to the following assessment at base line and at follow up after 6 months: Clinical evaluation, MSUS examination and laboratory evaluation.ResultsOf the 40 patients, 6 patients (15%) had systemic onset subtype, 8 (20%) oligoarticular extended, 9 (22.5%) oligoarticular persistent, 5 (12.5%) polyarticular rheumatoid factor (RF) +ve, 6 (15%) polyarticular RF −ve, 5 (12.5%) enthesitis related subtype and only one patient (2.5%) had psoriatic JIA. MSUS detected more synovitis than clinical examination (subclinical synovitis) both at base line and at follow up. MSUS is highly sensitive for early detection of joint involvement in JIA when compared to physical examination. Significant decrease in the mean cartilage thickness of the patients measured at follow up as compared to measures at base line.ConclusionMSUS is highly sensitive for early detection of joint involvement in JIA when compared to physical examination

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Section: Discussionsupporting

confidence: 88%

Implementation of musculoskeletal ultrasonography in detection of early juvenile idiopathic arthritis

Darwish

ismael

Ell-Laban

et al. 2016

European Journal of Radiology Open

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“…19,32,44 Imaging only-detected disease activity or subclinical synovitis has been shown to correlate with progression of joint damage in adults with rheumatoid arthritis (RA). 45 Magni-Manzoni et al 30 showed that although subclinical synovitis in their cohort of 39 children was common (77%), 67% of children remained in clinical remission after 2 years, concluding that subclinical synovitis does not predict subsequent flare.…”

Section: Disease Activity Assessment and Comparison With Clinical Assmentioning

confidence: 99%

Juvenile idiopathic arthritis: what is the utility of ultrasound?

Basra

Humphries

2017

BJR

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Juvenile idiopathic arthritis (JIA) is a heterogeneous condition and an important cause of acquired disability in children. Evidence supports early treatment to prevent future complications. This relies on prompt diagnosis, achieved by a high index of clinical suspicion and supportive evidence, including the detection of joint and or tendon inflammation. Ultrasound is a readily accessible, well-tolerated, safe and accurate modality for assessing joints and the surrounding soft tissues. It can also be used to guide therapy into those joints and tendon sheaths resistant to systemic treatments. Ultrasound imaging is highly operator dependent, and the developing skeleton poses unique challenges in interpretation with sonographic findings that can mimic pathology and vice versa. Ultrasound technology has been rapidly improving and is more accessible than ever before. In this article, we review the normal appearances, highlight potential pitfalls and present the key pathological findings commonly seen in JIA.

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“…[15][16][17][18][19][20][21] It has been suggested that US may be more sensitive in detecting joint inflammation in patients with JIA than the clinical evaluation. [22][23][24][25][26][27] However, the role of US-detected synovitis when clinical manifestations in JIA are absent is unknown. Furthermore, the only published study on the role of US in predicting JIA relapse showed no predictability.…”

Section: Introductionmentioning

confidence: 99%

Correction: Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham Osteoarthritis Study

2018

Ann Rheum Dis

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Detection of Active Disease in Juvenile Idiopathic Arthritis: Sensitivity and Specificity of the Physical Examination vs Ultrasound

Cited by 69 publications

References 13 publications

Implementation of musculoskeletal ultrasonography in detection of early juvenile idiopathic arthritis

Implementation of musculoskeletal ultrasonography in detection of early juvenile idiopathic arthritis

Juvenile idiopathic arthritis: what is the utility of ultrasound?

Correction: Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham Osteoarthritis Study

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