Comparison of clinical and ultrasonographic evaluations for peripheral synovitis in juvenile idiopathic arthritis
| Autor: | Alain Saraux, Loic de Parscau, Sandrine Jousse-Joulin, Luc Bressolette, Sylvain Breton, Danielle Colin, Claire Cangemi, Valérie Devauchelle-Pensec |
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| Přispěvatelé: | Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, CHRU de Brest - Département de Pédiatrie (CHU BREST Pédiatrie), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Réseau Maladies Métaboliques, Hôpitaux Universitaires du Grand Ouest, Service de Pédiatrie et Génétique Médicale, Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato) |
| Rok vydání: | 2010 |
| Předmět: |
Male
MESH: Range of Motion Articular MESH: Synovitis Arthritis Severity of Illness Index 030218 nuclear medicine & medical imaging 0302 clinical medicine MESH: Child Range of Motion Articular Child Ultrasonography Synovitis medicine.diagnostic_test 3. Good health MESH: Joints medicine.anatomical_structure Joint pain Child Preschool [SDV.IMM]Life Sciences [q-bio]/Immunology Female Radiology medicine.symptom musculoskeletal diseases medicine.medical_specialty Adolescent Physical examination MESH: Physical Examination 03 medical and health sciences Rheumatology MESH: Severity of Illness Index Internal medicine medicine Synovial fluid Humans Physical Examination MESH: Adolescent 030203 arthritis & rheumatology MESH: Humans business.industry MESH: Child Preschool Metacarpophalangeal joint medicine.disease MESH: Male Arthritis Juvenile Surgery Anesthesiology and Pain Medicine MESH: Arthritis Juvenile Rheumatoid Joints business MESH: Female Juvenile rheumatoid arthritis |
| Zdroj: | Seminars in Arthritis and Rheumatism Seminars in Arthritis and Rheumatism, WB Saunders, 2011, 41 (2), pp.272-8. ⟨10.1016/j.semarthrit.2010.12.005⟩ |
| ISSN: | 1532-866X 0049-0172 |
| Popis: | International audience; OBJECTIVES: The characteristics of synovitis in juvenile idiopathic arthritis (JIA) are important to evaluate, as they define several clinical categories. The metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints are frequently involved. Few studies have investigated peripheral joint evaluation using ultrasonography, a sensitive tool for detecting subclinical synovitis. Our objectives here were to compare clinical and ultrasound evaluations of MCP and MTP joint synovitis and to determine the prevalence of predefined ultrasound abnormalities in JIA patients and healthy controls. METHODS: Standardized physical and ultrasound assessments of the same joints were done in 31 consecutive patients with JIA and 41 healthy volunteers. Joint pain, motion limitation, and swelling were recorded. Ultrasonography was performed on the same joints by 2 trained sonographers who recorded synovial fluid, synovial hypertrophy, erosion, and power Doppler signal. Intraobserver reproducibility of ultrasonography was assessed. RESULTS: Of 558 peripheral joints examined in JIA patients, 69 (12.5%) had ultrasonographic synovitis and 83 (15%) had abnormal physical findings. All the physical abnormalities were significantly associated with ultrasonographic synovitis (P < 0.0001) but agreement was low between ultrasonographic and physical findings. Ultrasonographic synovitis was most common at the feet (59.4%), where it was detected clinically in only 25% of cases. Ultrasonographic synovitis was associated with the presence of synovial fluid. Cartilage vascularization was found in 2 (4.2%) healthy controls. CONCLUSION: Ultrasonography is useful for monitoring synovitis in JIA. Subclinical involvement of the MTP joints is common. Clinicians should be aware of the specific ultrasonographic findings in children. |
| Databáze: | OpenAIRE |
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