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Ultrasonographic examination in juvenile idiopathic arthritis is better than clinical examination for identification of intraarticular disease.
MedLine Citation:
PMID:  23905562     Owner:  NLM     Status:  In-Data-Review    
INTRODUCTION: The diagnosis of juvenile idiopathic arth-ritis (JIA) is formally based on clinical examination, but ultrasound (US) examination is used increasingly. Our purpose was to compare US and clinical examination in the assessment of synovitis in JIA.
MATERIAL AND METHODS: This study was retrospective and included 62 consecutive patients with newly diagnosed JIA admitted to the Department of Paediatrics at Gentofte Hospital, Denmark from 2003 to 2010. The included patients were examined clinically and by US at their first visit. All peripheral joints were examined clinically, 24% of these joints were examined by US. The development of new, clin-ically arthritic joints was followed during the next six months.
RESULTS: The mean sensitivity of clinical examination was 48% with a clear hierarchy among joints, knees having the highest sensitivity, small joints of hands and feet the lowest. On average, 0.4 joints per child, which were arthritic by clinical examination, were negative by US. Inversely, US detected 1.3 more arthritic joints than clinical examination did per child. The latter is a minimum estimate since only 24% of the joints were examined by US. Subclinically arthritic joints had a 29% probability of developing clinical arthritis within the first six months following the initial examination.
CONCLUSION: Although there is no formal validation of US examination in children suspected for JIA, we recommend that it is used routinely and performed by a highly experienced US operator.
FUNDING: not relevant.
Hans Erik Nielsen; Charlotte Strandberg; Steen Andersen; Christina Kinnander; Gunna Erichsen
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Danish medical journal     Volume:  60     ISSN:  2245-1919     ISO Abbreviation:  Dan Med J     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-08-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101576205     Medline TA:  Dan Med J     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  A4669     Citation Subset:  IM    
Hostrups Have 58, 1954 Frederiksberg C, Denmark.
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