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Pediatr Radiol. 2007 May;37(5):475-82. Epub 2007 Mar 20.

US findings of metacarpophalangeal joints in children with idiopathic juvenile arthritis.

Author information

1
Radiology, Riley Hospital for Children, Indianapolis, IN 46202-5200, USA. bkarmazy@iupui.edu

Abstract

BACKGROUND:

Juvenile idiopathic arthritis (JIA) is the most common cause of chronic arthritis in children, with frequent involvement of the metacarpophalangeal joints (MCPJ).

OBJECTIVE:

To compare US findings with those of radiography and clinical examination.

MATERIALS AND METHODS:

All MCPJs in 20 children with JIA (17 females, median age 9.7 years, range 3.6 to 16.8 years) were evaluated clinically and imaged with gray-scale and color Doppler US, and 90 MCPJs were also imaged radiographically. Each MCPJ was graded on physical examination from 0 (normal) to 4 (severe) by the patient's rheumatologist.

RESULTS:

US demonstrated abnormalities in 64 of 200 MCPJs (32.0%), including pannus vascularity and/or tenosynovitis in 55 joints (27.5%) (pannus vascularity in 43, tenosynovitis in 40) and bone destruction in 25 joints (12.5%). Overall, US abnormalities and physical examination scores were significantly associated (P < 0.001). However, interobserver agreement between US and clinical evaluation was poor (kappa 0.1) and between US and radiography was only fair (kappa 0.4).

CONCLUSION:

US of the MCPJ in children with JIA can demonstrate cartilage thinning, bone erosions, and pannus vascularity. Abnormal US findings are significantly correlated with severity of disease as evaluated clinically.

PMID:
17415601
DOI:
10.1007/s00247-007-0438-9
[Indexed for MEDLINE]

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