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Ultrasonography (US) in juvenile idiopathic arthritis (JIA): diagnosis, treatment and follow-up of ankle involvement

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Introduction

The aim of this study was to evaluate the usefulness of US and Doppler-US of the ankle region in children with JIA, for diagnosis of inflammation, guidance of steroid injection and follow-up.

Materials and methods

15 ankle regions with clinical signs of arthritis were examined with US and Doppler-US in 12 children, 9 girls and 3 boys between 2 and 14 years (mean 6.5 years, median 5 years).

US demonstrated inflammation in 24 compartments: 12 talocrural-, 6 subtalar-, 1 talonavicular joint and 5 tendonsheaths, respectively. US-guided steroid injection was successfully performed and the effect on synovial hypertrophy, effusion and synovial hyperaemia was measured after 1 and 4 weeks.

Results

At start synovial hypertrophy was found in 24, effusion in 8 and synovial hyperaemia in 23 compartments (Table 1).

Table 1 Results at follow-up with US and Doppler-US after US-guided steroid injection

Conclusion

US is a valuable tool to determine the exact location of synovitis, in guiding steroid injections and for follow-up in JIA. In our preliminary study there was improvement of the inflammation in a majority of compartments. Further research of the application of US in the paediatric population is needed before firm conclusions of its clinical value can be drawn.

Author information

Correspondence to L Laurell.

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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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Laurell, L., Court-Payen, M., Nielsen, S. et al. Ultrasonography (US) in juvenile idiopathic arthritis (JIA): diagnosis, treatment and follow-up of ankle involvement. Pediatr Rheumatol 6, P97 (2008) doi:10.1186/1546-0096-6-S1-P97

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Keywords

  • Public Health
  • Arthritis
  • Steroid
  • Clinical Sign
  • Juvenile Idiopathic Arthritis