Ultrasonography for detecting enthesitis in juvenile idiopathic arthritis
| Autor: | Sandrine Jousse-Joulin, Alain Saraux, Claire Cangemi, Valérie Devauchelle-Pensec, Bertrand Fenoll, Sylvain Breton, Luc Bressolette, Loic de Parscau |
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| Přispěvatelé: | Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), CHRU de Brest - Département de Pédiatrie (CHU BREST Pédiatrie), Réseau Maladies Métaboliques, Hôpitaux Universitaires du Grand Ouest, Service de Pédiatrie et Génétique Médicale |
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Bursitis Adolescent MESH: Rheumatic Diseases 03 medical and health sciences 0302 clinical medicine Rheumatology Rheumatic Diseases MESH: Child medicine Humans 030212 general & internal medicine Child 030203 arthritis & rheumatology MESH: Adolescent Achilles tendon Oligoarthritis MESH: Humans business.industry Patellar ligament Enthesitis Ultrasonography Doppler medicine.disease Enthesis Arthritis Juvenile MESH: Male 3. Good health Surgery medicine.anatomical_structure MESH: Tendinopathy Tendinopathy MESH: Ultrasonography Doppler MESH: Arthritis Juvenile Rheumatoid [SDV.IMM]Life Sciences [q-bio]/Immunology Polyarthritis Female Radiology medicine.symptom business MESH: Female Juvenile rheumatoid arthritis |
| Zdroj: | Arthritis Care & Research = Arthritis Care and Research Arthritis Care & Research = Arthritis Care and Research, Wiley-Blackwell, 2011, 63 (6), pp.849-55. ⟨10.1002/acr.20444⟩ |
| ISSN: | 0893-7524 1529-0123 |
| DOI: | 10.1002/acr.20444⟩ |
| Popis: | Objective Enthesitis is a major feature of juvenile idiopathic arthritis (JIA) but is difficult to diagnose clinically. Our objective was to compare the accuracy of ultrasonography with power Doppler (US-PD) versus clinical examination for diagnosing enthesitis in patients with JIA and healthy controls. Methods Twenty-six consecutive patients with JIA and 41 healthy volunteers underwent standardized clinical and US-PD examinations of 5 entheseal sites (proximal and distal quadricepital tendon insertions, Achilles tendon, and plantar fascia). US-PD reproducibility was evaluated. US-PD enthesitis was defined as a PD signal at the enthesis insertion. Bursitis, erosions, and cartilage vascularization were recorded. Results In the JIA group, 27 (12.5%) of the entheseal sites exhibited clinical enthesitis (distal patellar ligament in 45% of cases) and 20 (9.4%) exhibited US-PD enthesitis (distal patellar tendon in 30%), including 10 clinically normal sites (50%). US-PD enthesitis was found in several patients with oligoarthritis or polyarthritis. Clinical enthesitis (P < 0.0001) and HLA–B27–positive (P = 0.05) status were significantly associated with US-PD enthesitis. Erosion and bursitis, but not tendon thickening, were associated with US-PD enthesitis. US-PD enthesitis was not found at any of the 410 entheseal sites in controls; grade 1 cartilage vascularization was noted at 6% of the control sites. Conclusion Enthesitis is a rare phenomenon in JIA. Clinically silent enthesitis is detected by US-PD and can be found in JIA categories other than enthesitis-related arthritis. Tendon thickening and cartilage vascularization can be detected in healthy controls. These findings may have implications for patient classification of the use of US-PD. |
| Databáze: | OpenAIRE |
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