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US findings of metacarpophalangeal joints in children with idiopathic juvenile arthritis

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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.

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Acknowledgements

The authors gratefully acknowledge S. Gregory Jennings for his editorial assistance and Rhonda Gerding for her secretarial assistance.

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Authors and Affiliations

  1. Radiology, Riley Hospital for Children, 702 Barnhill Drive, Room 1053, Indianapolis, IN, 46202-5200, USA

    Boaz Karmazyn

  2. Radiology, University Hospital, Indianapolis, IN, USA

    Kenneth Buckwalter

  3. Pediatric Rheumatology, Indiana University, Indianapolis, IN, USA

    Suzanne L. Bowyer, Kara Murphy Schmidt, Susan H. Ballinger & Thuy T. Beam

  4. Biostatistics, Institute for the Study of Health, University of Cincinnati, Cincinnati, OH, USA

    Jun Ying

Authors
  1. Boaz Karmazyn
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  2. Suzanne L. Bowyer
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  6. Thuy T. Beam
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  7. Jun Ying
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Correspondence to Boaz Karmazyn.

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Karmazyn, B., Bowyer, S.L., Schmidt, K.M. et al. US findings of metacarpophalangeal joints in children with idiopathic juvenile arthritis. Pediatr Radiol 37, 475–482 (2007). https://doi.org/10.1007/s00247-007-0438-9

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  • DOI: https://doi.org/10.1007/s00247-007-0438-9

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