期刊
JOURNAL OF RHEUMATOLOGY
卷 45, 期 6, 页码 851-857出版社
J RHEUMATOL PUBL CO
DOI: 10.3899/jrheum.170681
关键词
MUSCULOSKELETAL ULTRASOUND; CLINICALLY INACTIVE DISEASE; POWER DOPPLER; JUVENILE IDIOPATHIC ARTHRITIS; JOINT EFFUSION; SYNOVIAL THICKENING
类别
资金
- CCTR at Seattle Children's Hospital
- US National Center for Advancing Translational Sciences
- US National Institutes of Health (NIH) [UL1 TR000002]
- Childhood Arthritis and Rheumatology Research Alliance (CARRA)
- Institute of Translational Health Sciences grant (National Center for Research Resources/NIH) [UL1 RR025014]
Objective. The validity of our current definitions for clinically inactive disease (CID) in juvenile idiopathic arthritis (JIA) based on physical examination is challenged by the development of advanced musculoskeletal imaging tools. We aimed to prospectively determine the prevalence of abnormal ultrasound (US) findings in children with CID in JIA and their clinical significance. Methods. Children aged >= 4 years with CID and a history of arthritis from a single tertiary center were approached over 1 year. Standard US of knees, tibiotalar joints, subtalar joints, and wrists were performed at baseline and at a followup visit. US images were scored by 2 pediatric musculoskeletal radiologists. Results. Forty children with CID were enrolled and followed clinically. The median duration of inactive disease was 1 year. The most common International League of Associations for Rheumatology JIA categories were extended oligoarticular JIA (30%) and rheumatoid factor-negative polyarthritis (38%). At baseline, among a total of 289 joints scanned, 24 joints (8%) had at least 1 abnormal finding in 18 (45%) of 40 subjects. When evaluated at the individual joint level against flares identified during followup exams, these baseline US findings had a sensitivity of 15% and a positive predictive value of 12%. The predictive performance of the second US was even less. Conclusion. Our study demonstrates that nearly half of children with CID had abnormal US findings in 1 of 8 commonly affected joints. These findings did not correlate with subsequent clinical flares in up to 2 years of followup.
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