Skip to main content

Advertisement

Table 1 Advantages and limitations of musculoskeletal ultrasound (MSUS) compared to magnetic resonance imaging (MRI) and conventional radiology in children with juvenile idiopathic arthritis

From: Ultrasound in juvenile idiopathic arthritis

Imaging modality Advantages Limitations
MSUS Lack of exposure to ionizing radiation
Rapidity of performance
Ease of repeatability
High patient acceptability
Demonstration of soft tissue inflammation
Direct visualization of cartilage
Early detection of bone erosions
Ability to scan multiple joints in a single session
Support in guidance of procedures (e.g. intra- articular corticosteroid injections)
Relatively inexpensive
Difficulties in carrying out in case of severe joint limitation
Relatively small field of view
Inability to assess the whole joint space
Acoustic shadowing from overlying bones
Limited value in the assessment of axial skeleton and temporomadibular joints
Dependency on the properties and sensitivity of the ultrasound equipment
Need of continuous practice after appropriate training
Reliability, standardization and validation in children under investigation
MRI Lack of exposure to ionizing radiation
Multiplanar tomographical imaging
Ability to assess the whole joint space
Demonstration of soft tissue inflammation
Direct visualization of cartilage
Early detection of bone erosions
Visualization of bone marrow oedema
High tissue contrast
Suitable for assessment of axial skeleton and temporomadibular joints
Intravenous contrast agent often required
Possible allergic reaction to contrast agents
General anesthesia required in younger children
Long examination time
Evaluation limited to one target joint
Reliability, standardization and validation in children under investigation
High cost
Variable availability worldwide
Conventional radiology Rapidity of performance
Applicability to all joints
Demonstration of joint space narrowing, disturbances of bone growth and maturation
Detection of bone erosions
Validated scoring methods in children
Suitable for longitudinal evaluation of damage progression
Low cost
Widespread availability
Exposure to ionizing radiations
Inability to directly visualize cartilage and soft tissue inflammation
Late detection of bone erosions and joint space narrowing
Projectional superimposition