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Musculoskeletal sonography in juvenile systemic lupus erythematosus

Objective

Musculoskeletal involvement of juvenile systemic lupus erythematosus (JSLE) is basically an arthralgia and/or arthritis attacking typically the small joints of the hands, wrists and knees. We aimed to demonstrate the role of sonography in depicting peri/articular changes in JSLE and to find out whether certain tendons of JSLE patients were different from those of healthy controls'.

Methods

Thirty JSLE patients (27 female, 3 male) were recruited for this study. For comparison of the sonographic data, 32 healthy volunteers were included as a control group. Sonographic evaluations were performed by a physiatrist experienced in musculoskeletal sonography.

Results

Knee effusion was observed more frequently in the JSLE group in comparison with the control subjects (p = 0.00). When tendon thickness measurements were compared between the groups, flexor and extensor tendons of the third digit (at MCP joint level) of JSLE patients were found to be thinner (p values being 0.04 and 0.03, respectively). Tendon thickness values did not correlate with disease duration and SLE disease activity index scores (p values > 0.05).

Conclusion

The main findings of our study were relevant with i) increased involvement of the following sites in JSLE; knee, ankle, hand extensor tendons, wrist, elbow, hand flexor tendons (in decreasing order of frequencies) and ii) decreased extensor/flexor tendon thicknesses in the hands of JSLE patients. Physicians should be aware of the potentially disabling scenario of tendon pathologies. Defining the extent of joint and tendon pathologies in Pediatric SLE may guide us in the management of the disease.

Author information

Correspondence to E Demirkaya.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Keywords

  • Systemic Lupus Erythematosus
  • Disease Activity Index
  • Flexor Tendon
  • Extensor Tendon
  • Sonographic Evaluation