Implementation of musculoskeletal ultrasonography in detection of early juvenile idiopathic arthritis

AIM: To determine whether early clinical, laboratory and musculoskeletal ultrasound (MSUS) characteristics can be used as early detectors of juvenile idiopathic arthritis. PATIENTS AND METHODS: Forty (40) patients with juvenile idiopathic arthritis (JIA) diagnosed according to the ILAR criteria [1] and 20 healthy control children. All patients were subjected to the following assessment at base line and at follow up after 6 months: Clinical evaluation, MSUS examination and laboratory evaluation. RESULTS: Of the 40 patients, 6 patients (15%) had systemic onset subtype, 8 (20%) oligoarticular extended, 9 (22.5%) oligoarticular persistent, 5 (12.5%) polyarticular rheumatoid factor (RF) +ve, 6 (15%) polyarticular RF −ve, 5 (12.5%) enthesitis related subtype and only one patient (2.5%) had psoriatic JIA. MSUS detected more synovitis than clinical examination (subclinical synovitis) both at base line and at follow up. MSUS is highly sensitive for early detection of joint involvement in JIA when compared to physical examination. Significant decrease in the mean cartilage thickness of the patients measured at follow up as compared to measures at base line. CONCLUSION: MSUS is highly sensitive for early detection of joint involvement in JIA when compared to physical examination