Sonography can effectively diagnose Juvenile Inflammatory Arthritis

May 7, 2011

venile-Inflammatory-Arthritis.aspx

Published on May 5, 2011

Juvenile Inflammatory Arthritis (JIA) is a potentially debilitating

childhood disease. Early detection and treatment of active arthritis may

avert long term joint damage and disability. Research has shown that

sonography with power Doppler can facilitate making assessments in joint

activity and sub-clinical disease, according to research being presented at

the 2011 American Roentgen Ray Society's annual meeting.

The study, performed at Albert Einstein College of Medicine's Montefiore

Medical Center, in Bronx, NY, compares sonography with power Doppler to

physical examination in evaluating disease activity in the knees and ankles

of children with JIA.

Eighty-four joints in 19 patients were evaluated; of these, 65 joints were

concordant on both sonography and physical examination. Of the remaining 19

joints, 14 were active on sonography and inactive on physical examination.

Five of the 14 joints were found to have subclinical disease at the time of

the initial physical examination, while 8 of the 14 joints demonstrated mild

hyperemia as the only indicator of disease activity on sonography, which was

a false positive. Of the 5 joints active on physical examination and

inactive on sonography, 4 had subtalar disease.

" In patients with at least one active joint on physical examination,

ultrasound augments the physical exam by identifying subclinical disease (in

other joints). Our study confirmed that patients with evidence of

subclinical disease do, in many cases, go on to have clinically evident

disease, " said Vikash Panghaal, MD, lead author of the study.

" Certain combinations of physical exam findings are highly sensitive, and in

these instances, ultrasound does not contribute to clinical management.

Subtalar disease is poorly assessed using ultrasound, " he said.

" Unlike previous studies, our study included a 2-5 month follow-up physical

exam after the initial physical exam and ultrasound, which allowed

confirmation of subclinical disease, " said Dr. Panghaal.

" We also determined the sensitivity and specificity of various aspects of

the physical exam for identifying synovitis and correlated this

withultrasound findings, " said Dr. Panghaal.

Source: American Roentgen Ray Society

Recommended Posts