Role of musculoskeletal ultrasonography in the detection of subclinical synovitis in oligo and polyarticular juvenile idiopathic arthritis children

El-Banna, Hanaa Samy; Nada, Doaa Waseem; Hussein, Manal Shawky; Hablas, Shymaa Ahmed; Darwish, Nivine F; Abu-Zaid, Mohammed Hassan; Gadou, Suzan E.

doi:10.1016/j.ejr.2018.05.008

Cited by 7 publications

(5 citation statements)

References 28 publications

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“…A previous study [15] confirmed our finding: US abnormalities were most frequently found in knees followed by wrists and MCP joints. In concordance with a prior study [23], there was a significant difference among JIA subtypes as regards different US features attributed to the higher US scores in SJIA cases. Scores done by the US for synovial effusion, hypertrophy, positive PD signals, and the total US severity score were all significantly correlated to most of disease assessment indices.…”

Section: Discussionsupporting

confidence: 90%

Ultrasound Features across Subtypes of Juvenile Idiopathic Arthritis

2022

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Objective: The aim of this study was to evaluate musculoskeletal ultrasound (MSUS) features across categories of juvenile idiopathic arthritis (JIA). Methods: In this cross-sectional study, all patients were subjected to full history taking, clinical examination including disease assessment parameters and laboratory investigations. In addition, all children were examined by both grayscale (GS) and power Doppler (PD) MSUS images. Results: By MSUS, the number of joints with synovial effusion was 697 of a total 2400 examined joints (29%) and joints with synovial thickening counted 673 (28%). The number of joints with positive PD signals was 446 (18.6%). There was a significant difference among JIA subtypes as regards different MSUS features. Moreover, there was a discrepancy regarding synovial effusion (p = 0.018), hypertrophy scores (p = 0.013), and the total US severity score (p = 0.026). This divergence was attributed to the significant difference between systemic juvenile idiopathic arthritis (SJIA) and other categories. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MSUS in JIA and its subtypes were calculated. Conclusion: MSUS is a highly sensitive method for detecting synovitis, tenosynovitis, and erosive bone disease, and it helps to make proper therapeutic decisions. There was a significant difference among JIA subtypes regarding MSUS features.

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Section: Discussionsupporting

confidence: 90%

Ultrasound Features across Subtypes of Juvenile Idiopathic Arthritis

2022

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“…3,12 The authors were unable to locate any published works evaluating the ability of sonography to quantify synovial volume in JIA. 2 2007 Retrospective observational n = 152 Lanni et al 3 2013 Literature review Not reported Laurell et al 4 2011 Case series n = 30 Collado et al 5 2012 Literature review x = 20 El-Banna et al 6 2018 Case series n = 40 Darwish et al 7 2016 Case-control n = 40 Ventura-Rios et al 8 2018 Cross-sectional n = 30 Colebatch-Bourn et al 9 2015 Literature review x = 204 Lotfy et al 10 2018 Cross-sectional n = 40 Hassan et al 11 2015 Cross-sectional n = 20 Ramos et al 12 2012 Literature review Not reported Chauvin et al 13 2016 Literature review Not reported Shanmugavel et al 14 2008 Case series n = 30 Kakati et al 15 2007 Case series n = 30 Magni-Manzoni et al 16 2013 Case series n = 39 Hechler et al 18 2018 Literature review x = 6 Damasio et al 19 2010 Literature review Not reported Jousse-Joulin et al 20 2011 Cross-sectional n = 26 Shenoy and Aggarwal 21 2016 Cross-sectional n = 30 Pradsgaard et al 22 2013 Cross-sectional n = 95 Pradsgaard et al 23 2015 Cross-sectional n = 23 Spannow et al 24 2009 Case series n = 74 Spannow et al 25 2011 Cross-sectional n = 25 Magni-Manzoni et al 26 2016 Literature review Not reported Magni-Manzoni et al 27 2012 Literature review Not reported…”

Section: Resultsmentioning

confidence: 99%

“…MSKS has been shown to be superior to the clinical examination as it pertains to detecting early signs of JIA. [5][6][7][8] In one study in which 1664 joints of 32 patients were assessed both clinically and with sonography, sonographic imaging revealed synovitis in 86 clinically normal joints. The same study also reports interobserver reliability scores of 83%, 84%, and 95% for the presence/absence of joint effusion, synovial hypertrophy and power Doppler signal, respectively.…”

Section: Resultsmentioning

confidence: 99%

The Role of Ultrasound in Juvenile Idiopathic Arthritis: A Narrative Review From an Imaging Perspective

Dima

Appea

2019

Journal of Diagnostic Medical Sonography

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Objective: Musculoskeletal sonography (MSKS) is increasingly being used in the setting of juvenile idiopathic arthritis (JIA). The purpose of this narrative review was to describe the role of sonography in JIA and outline strategies for operators of pediatric MSKS. Methods: A literature review through multiple medical databases was conducted by restricting the search to medical subject headings (MeSH). Peer-reviewed English-language articles from 2007 to 2018 were included, which focused the on common sonographic findings of JIA. Results: Twenty-six articles were selected for inclusion in the study after a complete reading. Many studies aimed to address the validity of sonographic techniques in the assessment of JIA, but few studies discussed the specific sonographic appearances of JIA, scanning pitfalls, and appropriate imaging techniques. Conclusion: MSKS reveals subclinical manifestations of arthropathy, but the true value of detecting subclinical disease is not well understood. MSKS is limited in the evaluation of articular cartilage thinning and bony erosions. Responsiveness of MSKS in JIA remains to be formally assessed with higher quality studies.

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“…In clinical practice, US is the primary technique used to detect and follow up on synovitis, tenosynovitis, bursitis, and enthesitis—the main pathologies in peripheral joints in JIA—having better sensitivity than clinical examination [ 12 , 20 , 21 , 22 ]. While synovitis and tenosynovitis are the main abnormalities in JIA, enthesitis is a rare pathology, mainly concerning the enthesitis-related arthritis (ERA) subtype of JIA.…”

Section: Update In Ultrasoundmentioning

confidence: 99%

Advances in Musculoskeletal Imaging in Juvenile Idiopathic Arthritis

et al. 2022

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Over the past decade, imaging of inflammatory arthritis in juvenile arthropathies has significantly advanced due to technological improvements in the imaging modalities and elaboration of imaging recommendations and protocols through systematic international collaboration. This review presents the latest developments in ultrasound (US) and magnetic resonance imaging (MRI) of the peripheral and axial joints in juvenile idiopathic arthritis. In the field of US, the ultra-wideband and ultra-high-frequency transducers provide outstanding spatial resolution. The more sensitive Doppler options further improve the assessment and quantification of the vascularization of inflamed tissues, and shear wave elastography enables the diagnosis of tissue stiffness. Concerning MRI, substantial progress has been achieved due to technological improvements in combination with the development of semiquantitative scoring systems for the assessment of inflammation and the introduction of new definitions addressing the pediatric population. New solutions, such as superb microflow imaging, shear wave elastography, volume-interpolated breath-hold examination, and MRI-based synthetic computed tomography open new diagnostic possibilities and, at the same time, pose new challenges in terms of clinical applications and the interpretation of findings.

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Role of musculoskeletal ultrasonography in the detection of subclinical synovitis in oligo and polyarticular juvenile idiopathic arthritis children

Cited by 7 publications

References 28 publications

Ultrasound Features across Subtypes of Juvenile Idiopathic Arthritis

Ultrasound Features across Subtypes of Juvenile Idiopathic Arthritis

The Role of Ultrasound in Juvenile Idiopathic Arthritis: A Narrative Review From an Imaging Perspective

Advances in Musculoskeletal Imaging in Juvenile Idiopathic Arthritis

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