To evaluate bone quality in children with juvenile idiopathic arthritis

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Quantitative ultrasonometry of the calcaneus in children with juvenile

idiopathic arthritis

Rheumatology 2006 45(10):1273-1275; doi:10.1093/rheumatology/kel028

http://rheumatology.oxfordjournals.org/cgi/content/abstract/45/10/1273

Objectives. To evaluate bone quality by means of quantitative ultrasonometry

(QUS) in children with juvenile idiopathic arthritis (JIA).

Methods. Seventy children [37 with oligoarticular JIA, mean age (±S.D.)

10.54 ± 3.42 yr; and 33 with polyarticular rheumatoid factor negative JIA,

mean age (± S.D.) 11.33 ± 2.88 yr] were enrolled. Quantitative

ultrasonometry was measured on both heels with a Cuba Clinical portable

device. Body height, weight and body mass index were recorded together with

disease duration and cumulative dose of prednisone.

Results. The lowest QUS parameters were observed in children with

polyarticular JIA (P< 0.001 and 0.01 when compared with reference data and

oligoarticular JIA, respectively). In children with oligoarticular JIA, the

QUS values were also significantly lower in comparison with the reference

data (P< 0.002). The QUS parameters were strongly influenced by body height,

and to a lesser degree by body weight. In children with polyarticular JIA,

there were significant inverse correlations between QUS parameters and

disease duration [r=-0.57, P< 0.01 for broadband ultrasound attenuation

(BUA) and r = - 0.67, P< 0.01 for velocity of sound (VOS)]. Similarly, there

were inverse correlations between QUS and cumulative dose of prednisone (r

= - 0.48, P< 0.05 for BUA and r =- 0.50, P < 0.01 for VOS, respectively).

Similar results were obtained when BUA and VOS were adjusted for height.

Conclusions. Disease duration and cumulative dose of prednisone in children

with polyarticular JIA are risk factors of stunted growth and decreased QUS

values of bone quality.

S. Kutilek, M. Bayer, P. Dolezalova and D. Nemcova

Department of Pediatrics, 1st Medical Faculty, University, Prague,

Czech Republic.

Correspondence to: S. Kutilek, Center for Clinical and Basic Research

(CCBR), Kyjevská 40, 530 03 Pardubice, Czech Republic. E-mail: sk@...