Ultrasound Shows Pathology in Joints Despite Remission

Pathology detected in idiopathic arthritis may assist with assessment in children

WEDNESDAY, April 20 (HealthDay News) -- Children with juvenile idiopathic arthritis (JIA) in clinical remission may continue to show signs of pathology on joint ultrasounds, which may be indicative of ongoing inflammation, according to a study published online April 11 in Arthritis Care & Research.

Monica Rebollo-Polo, M.D., from the Children's Hospital of Eastern Ontario in Ottawa, Canada, and colleagues evaluated whether pathological findings could be seen on grey scale or Power Doppler ultrasound of the joints of 28 children with JIA who were in clinical remission. Ultrasonography was performed on the wrist, knee, and ankle on previously affected and unaffected joints. The images were read and classified as structural abnormalities in the case of synovial thickening or Power Doppler Positive in the case of an abnormal Power Doppler signal.

The investigators found that eight of 14 patients with previous wrist involvement had pathologic grey scale and three had pathologic Doppler findings in the wrist. Neither pathologic grey scale nor Doppler findings were found in any of the 20 patients with previous knee involvement. Pathologic grey scale was seen in six of the 15 patients with previous ankle involvement, and pathologic Doppler findings in the tibiotalar joint were noted in only one of the 15 patients.

"In the future, ultrasound will likely play an important role in the assessment of joint disease activity in the pediatric population, as is the case for assessment of rheumatoid arthritis in adults," the authors write.

Two of the study authors disclosed financial ties to the pharmaceutical industry.

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