What’s new in musculoskeletal ultrasound in pediatric rheumatology?

Spârchez, Mihaela; Fodor, Daniela

doi:10.11152/mu-1604

Cited by 10 publications

(4 citation statements)

References 49 publications

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“…The MSUS features of indicator joint in different subtypes of JIA Effusion, synovial hypertrophy, and enthesopathy are main MSUS features of involved joints of JIA [14,23]. Figure 3 summarized the presence of above 3 features in joints of different subtypes.…”

Section: Disease Activity and Physical Function Scoresmentioning

confidence: 98%

Utilizing ultrasound findings of a single indicator joint to assess non-systemic juvenile idiopathic arthritis

Huang

Liao

et al. 2020

Preprint

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Background: Musculoskeletal ultrasound (MSUS) has been used worldwide in adult patients with rheumatoid arthritis (RA) but is beginning to play an increasing role in patients with juvenile idiopathic arthritis (JIA). The aim of this study was to investigate the application of MSUS findings of a single indicator joint in JIA to assess the disease activity and classify disease subtype.Methods: Thirty-five non-systemic JIA patients with a total of 62 visits were retrospectively recruited in this study. Among the involved joints, the joint with highest value of grey-scale (GS) plus power Doppler (PD) (=GSPD) was selected as the indicator joint at each visit. The correlations between each MSUS parameter (GS, PD, GSPD) of indicator joints and the Physician Global Assessment (PGA) score, the Childhood Health Assessment Questionnaire‐disability index (CHAQ-DI), and laboratory data were analyzed. The ultrasound features in different subtypes of JIA were also compared.Results: PD was weakly correlated with the PGA score (rho=0.323, p=0.010), while both GS and GSPD were moderately correlated with the PGA score (rho=0.405, p=0.001; rho=0.434, p=0.000). On the other hand, GS, PD, and GSPD were weakly correlated with CHAQ-DI. Although erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) had a weak correlation with PGA, they were not statistically correlated with GS, PD, or GSPD. The proportions of effusion, synovial hypertrophy, and enthesopathy in three different subtypes, showed significant differences (Fisher’s exact test, p=0.037; p=0.004; p=0.019). Enthesopathy was only seen in joints of enthesitis-related arthritis (ERA), but not in joints of polyarthritis and oligoarthritis.Conclusions: MSUS is an acceptable non-invasive tool for the patients with JIA, particularly for those with non-systemic JIA, that might assist disease classification, and whose parameters of the indicator joints may potentially contribute to the evaluation of disease activity.

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Section: Disease Activity and Physical Function Scoresmentioning

confidence: 98%

Utilizing ultrasound findings of a single indicator joint to assess non-systemic juvenile idiopathic arthritis

Huang

Liao

et al. 2020

Preprint

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“…Although US-detected subclinical synovitis has not been determined as a predictor of flares in a recent study, 8 increased rate of flare has been reported in patients in clinical remission but presenting positive Doppler findings. 9 Thus early initial diagnosis and also detection of disease activity are crucial for achieving treatment response and reducing the sequelae. Since we have excluded patients with severe contractures, diagnostic accuracy of SWE for differentiation of JIA disease has failed to reach statistically significant levels.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Periarticular Soft Tissues in Patients With Juvenile Idiopathic Arthritis by Superb Microvascular Imaging and Shear Wave Elastography

2020

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Objectives: This study aims to compare the vascularity and elasticity of periarticular soft tissues by superb microvascular imaging (SMI) and power Doppler (PD) ultrasound along with shear wave elastography (SWE) between children with juvenile idiopathic arthritis (JIA) and healthy children. Patients and methods: This prospective single center study, conducted between March 2018 and May 2018, included 22 children with JIA (14 males, 8 females; mean age 11.3±5 years; range, 5 to 17 years) and 24 healthy pediatric volunteers (12 males, 12 females; mean age 13±5.5 years; range, 7 to 17 years). Quadriceps tendon (QT), patellar tendon (PT), infraarticular and supraarticular soft tissue elasticities were calculated via SWE. Supraarticular and infraarticular soft tissue vascularity index (VI) were evaluated via SMI and PD. Results: No significant difference was found among the mean ages of the participants in study and control groups. Mean VI of both supraarticular (8.15%) and infraarticular soft tissues (7.9%) by SMI were significantly higher in study group compared to control group (2.88% vs. 2.57%, respectively). Mean VI of both supraarticular (9.1%) and infraarticular soft tissues (8.12%) by PD were significantly higher in study group compared to control group (3.4% vs. 3.1%, respectively). Highly significant good positive correlation was found between VI values obtained with PD and SMI (r=0.9, p=0.001). There was a significant moderate positive correlation between the mean elasticity of the QT with VI of the supraarticular soft tissues by SMI (r=0.4, p=0.003). There was a significant moderate positive correlation of VI of infraarticular soft tissues by SMI with mean elasiticity of PT (r=0.42, p=0.002). Conclusion: Vascularity index by SMI and PD could differentiate patients with JIA from healthy subjects. The SWE examination of tendons and soft tissues did not show any significant difference among patients with JIA and healthy subjects.

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“…Early initial diagnosis and early detection of disease activity are crucial for achieving treatment response and reducing the disease sequelae [ 30 ]. Remission status is more accurately diagnosed by US than clinical examination; however, the prognostic value of subclinical synovitis is still being defined [ 12 , 32 , 33 ]. These issues became even more challenging given SMI sensitivity.…”

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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What’s new in musculoskeletal ultrasound in pediatric rheumatology?

Cited by 10 publications

References 49 publications

Utilizing ultrasound findings of a single indicator joint to assess non-systemic juvenile idiopathic arthritis

Utilizing ultrasound findings of a single indicator joint to assess non-systemic juvenile idiopathic arthritis

Evaluation of Periarticular Soft Tissues in Patients With Juvenile Idiopathic Arthritis by Superb Microvascular Imaging and Shear Wave Elastography

Advances in Musculoskeletal Imaging in Juvenile Idiopathic Arthritis

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