Ultrasound detects clinically silent enthesitis in juvenile idiopathic arthritis

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Ultrasound Detects Silent Enthesitis in Arthritis

Power Doppler ultrasound detects clinically silent enthesitis in juvenile

idiopathic arthritis

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Publish date: Feb 23, 2011

(HealthDay News) -- Ultrasonography with power Doppler (US-PD) may detect

clinically silent enthesitis in patients with juvenile idiopathic arthritis

(JIA) and other enthesitis-related arthritis, according to research

published online Feb. 10 in Arthritis Care & Research.

Sandrine Jousse-Joulin, M.D., from Université de Bretagne Occidentale in

Brest, France, and colleagues evaluated 26 patients with JIA and 41 healthy

controls for enthesitis.

Standardized clinical and US-PD examinations were compared for five

entheseal sites (Achilles tendon, proximal and distal patellar ligament,

quadricepital tendon, and plantar fascia insertions). The presence of

cartilage vascularization, bursitis, and erosions was recorded.

The investigators found that clinical enthesitis was exhibited in 12.5

percent of sites in the JIA group, with 45 percent at the distal patellar

ligament. In 10.5 percent of sites, US-PD enthesitis was displayed with 50

percent at clinically normal sites. US-PD was also seen in patients with

oligoarthritis or polyarthritis. A significant association was found between

clinical enthesitis and HLA-B27-positive status and US-PD enthesitis.

In the JIA group, US-PD enthesitis was associated with erosion and bursitis,

but not with tendon thickening or cartilage vascularization.

No clinical or US-PD enthesitis, erosion, or bursitis, was detected at any

of the 410 entheseal sites in controls, but grade 1 cartilage

vascularization was found at 6 percent of sites.

" Given the limited sensitivity of the physical examination for detecting

enthesitis and the long time required for radiographic signs of enthesitis

to develop, US-PD may deserve to be included in the initial evaluation of

JIA, " the authors write.