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

Ting, Tracy V.; Vega‐Fernandez, Patricia; Oberle, Edward J; Ranieri, Deirdre De; Bükülmez, Hülya; Lin, Clara; Moser, David W.; Barrowman, Nicholas; Zhao, Yichao; Benham, Heather; Tasan, Laura; Thatayatikom, Akaluck; Roth, Johannes

doi:10.1002/acr.23746

Cited by 38 publications

(49 citation statements)

References 34 publications

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“…A severe or grade 3 knee shows significant distension of the suprapatellar recess between the undersurface of the quadriceps tendon and the pre-femoral fat pad, extension throughout the image, and the most proximal portion of the synovial recess is at >50% of the maximum distension of the recess. 18 For assessing PD scale, a normal PD or grade 0 knee includes the presence of no signal. Grade 1 includes one to three signals, or up to one confluent spot and two single spots, or up to two confluent spots within the area of synovial hypertrophy.…”

Section: Musculoskeletal Ultrasoundmentioning

confidence: 99%

Assessment of the relationship between knee ultrasound and clinical symptoms in patients with thyroid dysfunction

Kim

Park

et al. 2020

J Int Med Res

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Objective: To determine whether musculoskeletal ultrasound (MSUS) abnormalities were associated with thyroid dysfunction. Methods: This study included 109 patients with thyroid diseases, including thyroid dysfunction or autoimmune thyroid disease. Patients were categorized as euthyroid, hypothyroid, or hyperthyroid based on their recent thyroid function tests. To evaluate MSUS, an experienced rheumatologist examined the presence of synovial fluid, synovial hypertrophy, and grade of inflammation in both gray-scale and power Doppler scans of the knee joint. Associations between MSUS abnormalities, thyroid status, visual analog scale (VAS) score for knee pain, and presence of thyroid autoantibodies were investigated. Results: MSUS abnormalities were more frequently associated with hyperthyroid or hypothyroid states than with a euthyroid state. High knee VAS score was significantly associated with overall MSUS severity score regardless of knee osteoarthritis. However, there was no difference in MSUS abnormalities based on the presence of thyroid autoantibodies. Conclusions: Both hypothyroid and hyperthyroid states were associated with MSUS abnormalities and knee arthralgia. MSUS examination may be helpful in uncontrolled thyroid dysfunction and knee arthralgia.

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Section: Musculoskeletal Ultrasoundmentioning

confidence: 99%

Assessment of the relationship between knee ultrasound and clinical symptoms in patients with thyroid dysfunction

Kim

Park

et al. 2020

J Int Med Res

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“…The SI joints are affected in approximately 30% of children with the ERA subtype of JIA. Sacroiliitis is usually not seen in Hip Shelmerdine et al [50] Bertamino et al [51] NA NA Knee NA CARRA JIA Ultrasound Workgroup [52] Juvenile Arthritis MRI Score (JAMRIS) [53,54] the early course of the disease; children typically first present with enthesitis and lower extremity peripheral arthritis prior to developing SI joint involvement. Despite this, early identification of sacroiliitis is crucial, as treatment options are not only different than those for peripheral juvenile SpA, but there is also markedly increased long-term disability too.…”

Section: Sacroiliac Jointsmentioning

confidence: 99%

“…US plays an important role in differential diagnosis and can be useful for treatment monitoring as well as for guiding joint injections [52,87]. Knee US has some limitation.…”

Section: Kneementioning

confidence: 99%

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Imaging assessment of children presenting with suspected or known juvenile idiopathic arthritis: ESSR-ESPR points to consider

et al. 2020

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Juvenile idiopathic arthritis (JIA) is the most common paediatric rheumatic disease. It represents a group of heterogenous inflammatory disorders with unknown origin and is a diagnosis of exclusion in which imaging plays an important role. JIA is defined as arthritis of one or more joints that begins before the age of 16 years, persists for more than 6 weeks and is of unknown aetiology and pathophysiology. The clinical goal is early suppression of inflammation to prevent irreversible joint damage which has shifted the emphasis from detecting established joint damage to proactively detecting inflammatory change. This drives the need for imaging techniques that are more sensitive than conventional radiography in the evaluation of inflammatory processes as well as early osteochondral change. Physical examination has limited reliability, even if performed by an experienced clinician, emphasising the importance of imaging to aid in clinical decision-making. On behalf of the European Society of Musculoskeletal Radiology (ESSR) arthritis subcommittee and the European Society of Paediatric Radiology (ESPR) musculoskeletal imaging taskforce, based on literature review and/or expert opinion, we discuss paediatric-specific imaging characteristics of the most commonly involved, in literature best documented and clinically important joints in JIA, namely the temporomandibular joints (TMJs), spine, sacroiliac (SI) joints, wrists, hips and knees, followed by a clinically applicable point to consider for each joint. We will also touch upon controversies in the current literature that remain to be resolved with ongoing research. Key Points • Juvenile idiopathic arthritis (JIA) is the most common chronic paediatric rheumatic disease and, in JIA imaging, is increasingly important to aid in clinical decision-making. • Conventional radiographs have a lower sensitivity and specificity for detection of disease activity and early destructive change, as compared to MRI or ultrasound. Nonetheless, radiography remains important, particularly in narrowing the differential diagnosis and evaluating growth disturbances. • Mainly in peripheral joints, ultrasound can be helpful for assessment of inflammation and guiding joint injections. In JIA, MRI is the most validated technique. MRI should be considered as the modality of choice to assess the axial skeleton or where the clinical presentation overlaps with JIA.

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“…At the time we designed our protocol, to the best of our knowledge there were no published, validated scoring or grading systems for supra-patellar effusion caused by mechanical pathologies in pediatric knees. The referred scoring system [4] was published after our study. Furthermore, we find this classification, while very interesting and important, to be irrelevant to our study.…”

Section: Clinical Feature Letter To the Editormentioning

confidence: 99%

In response to: Ersatz ultrasonographic measurements for the knee joint

Stern

Siev-Ner

Tenenbaum

et al. 2018

The Physician and Sportsmedicine

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

Cited by 38 publications

References 34 publications

Assessment of the relationship between knee ultrasound and clinical symptoms in patients with thyroid dysfunction

Assessment of the relationship between knee ultrasound and clinical symptoms in patients with thyroid dysfunction

Imaging assessment of children presenting with suspected or known juvenile idiopathic arthritis: ESSR-ESPR points to consider

In response to: Ersatz ultrasonographic measurements for the knee joint

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