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  • Open Access

Musculo-skeletal Ultrasound in paediatric rheumatology: experience of one University Hospital

  • 1Email author,
  • 1,
  • 1 and
  • 1
Pediatric Rheumatology20119 (Suppl 1) :P42

https://doi.org/10.1186/1546-0096-9-S1-P42

  • Published:

Keywords

  • Synovial Membrane
  • Rheumatic Disease
  • Synovitis
  • Tenosynovitis
  • Paediatric Rheumatology

Introduction

Musculo-skeletal Ultrasound (MSK-US) has become essential in the diagnosis and follow-up of children with rheumatic diseases. It’s an innocuous exam that helps diagnostic and treatment decisions and allows treatment efficacy assessment.

Objectives

To evaluate the usefulness of MSK-US in the study of paediatric rheumatic inflammatory diseases.

Material and methods

Analysis of 330 MSK-US exams performed to 222 children with rheumatic inflammatory diseases in our Department. The children’s ages were between 1 and 18 years (average= 11,7±4,7 years) and 67,6% were female. Synovial membrane proliferation, intra-articular effusion, cartilage contour abnormalities, erosions and periarticular affections were searched in each joint. Clinical and ultrasonographic data were correlated.

Results

MSK-US detected synovitis in 100 of 194 exams (51,5%) of patients that had clinical suspicion of arthritis and in 36 of 136 exams (26,5%) of patients that presented with another symptom. In patients with clinical, but not ultrasonographic synovitis (94), we detected tenosynovitis in 13 cases (13,8%) and synovial cyst in 4 (4,3%). The remaining patients had no ultrasonographic changes.

Overall 39 exams showed ultrasonographic tenosynovitis, 15 (38,5%) of which had the clinical diagnosis too. MSK-US also identified erosions in 7 patients (2 had no ultrasonographic arthritis).

In total, 381 ultrasonographic diagnoses were made. Considering that 49,7% of the exams performed had no abnormalities, 1,3 diagnosis per exam were made.

Conclusions

MSK US confirms or excludes arthritis, which permits a fast treatment or correct therapeutic options, avoiding iatrogenesis in children. It also allows the diagnosis of other articular and periarticular affections, and ultrasound-guided procedures.

Authors’ Affiliations

(1)
Department of Rheumatology, Hospital de Santa Maria, Lisbon, Portugal

Copyright

© Dias et al; licensee BioMed Central Ltd. 2011

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://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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