Ultrasound findings on patients with juvenile idiopathic arthritis in clinical remission

Rebollo-Polo, Monica; Koujok, Khaldoun; Weisser, Caroline; Juřenčák, Roman; Bruns, Alessandra; Roth, Johannes

doi:10.1002/acr.20478

Cited by 87 publications

(50 citation statements)

References 24 publications

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“…In this respect, ultrasound has also been shown to be promising in identifying subclinical synovitis in patients with RA and JIA 35 38. However, its application in monitoring JIA is hampered by the absence of standardised definitions of ultrasound pathologies and of validated scoring systems in JIA.…”

Section: Discussionmentioning

confidence: 99%

MRI versus conventional measures of disease activity and structural damage in evaluating treatment efficacy in juvenile idiopathic arthritis

et al. 2012

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Section: Discussionmentioning

confidence: 99%

MRI versus conventional measures of disease activity and structural damage in evaluating treatment efficacy in juvenile idiopathic arthritis

et al. 2012

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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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“…Radiographic imaging studies demonstrate that erosive changes occur early, and there appears to be a small therapeutic 'window of opportunity' to prevent permanent damage and poor functional outcomes through pharmacological and rehabilitative interventions (7)(8). Moreover, recent studies employing musculoskeletal ultrasound (MSUS) demonstrate that subclinical signs of inflammation are common in the foot and ankle even in those who meet clinical remission criteria (9,10). Subclinical inflammation has also been associated with continued structural deterioration in adults with rheumatoid arthritis (RA) (11).…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of a multidisciplinary foot care program for children and adolescents with juvenile idiopathic arthritis: An exploratory trial

et al. 2013

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Objectives:To evaluate the effectiveness of multidisciplinary foot-care, and to evaluate the methodological considerations of a trial of multidisciplinary care in juvenile idiopathic arthritis. Design: Exploratory randomised controlled trial. Subjects/Patients: Children/adolescents with juvenile idiopathic arthritis and inflammatory joint disease affecting the foot/ankle. Methods: Standard medical care was compared with a 12 month program of multidisciplinary foot-care informed by musculoskeletal ultrasound. This program was centred on strict disease control through rigorous examination and interventions delivered by a team comprised of a paediatric rheumatologist, podiatrist, physiotherapist and musculoskeletal ultrasonographer. Patients were assessed on foot impairment and disability scores using the Juvenile Arthritis Foot Disability Index. Results: Forty-four participants, aged 3-17 years were randomly assigned to receive the experimental (n = 21) or usual care (n = 23) interventions. There was an overall improvement in levels of foot related impairments in both groups over 12 months. Between-group differences in change scores for the Juvenile Arthritis Foot Disability Index were not statistically significant at 6 or 12 month follow-ups. Conclusion: The integrated multidisciplinary foot care interventions described in this trial were safe, but did not improve foot impairment levels relative to usual care. This trial identified several methodological challenges including recruitment/retention, difficulties with outcome tools and potential confounders.

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Ultrasound findings on patients with juvenile idiopathic arthritis in clinical remission

Abstract: Conclusion. This study demonstrates that some patients who meet clinical criteria for remission continue to show ongoing pathology on joint ultrasound, which may be suggestive of persistent inflammation.

Cited by 87 publications

References 24 publications

MRI versus conventional measures of disease activity and structural damage in evaluating treatment efficacy in juvenile idiopathic arthritis

MRI versus conventional measures of disease activity and structural damage in evaluating treatment efficacy in juvenile idiopathic arthritis

Definitions for the Sonographic Features of Joints in Healthy Children

The effectiveness of a multidisciplinary foot care program for children and adolescents with juvenile idiopathic arthritis: An exploratory trial

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