High frequency power doppler ultrasonography in oligoarticular juvenile idiopathic arthritis: Correlation with disease severity

Aim of the workJuvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children and is a leading cause of acquired disability in the pediatric age. We aimed to detect subclinical synovitis in children with oligoarticular JIA using high frequency power Doppler ultrasonography (US) and correlate US scores with clinical disease severity.Patients and methodsHigh frequency power Doppler ultrasonography was done for both knees and ankles of 20 oligoarticular JIA patients. Assessment of clinical disease severity by articular index scores and functional assessment by the modified juvenile arthritis functionality scale (JAFS) were calculated for all patients.ResultsWe found 24 clinically active knees and 20 clinically active ankles. On comparison between clinical and ultrasonography activity, we found 13 clinically inactive joints, but they were active joints by ultrasonography. There was a highly significant difference (p < 0.001) between clinical and US activity as regards the number of affected joints. There was a highly significant (p < 0.01) positive correlation between clinical disease severity scores and all US scores except clinical score of range of motion (ROM); that did not show a significant positive correlation with US score of effusion (p > 0.05).ConclusionsHigh frequency power Doppler US may be useful in detecting subclinical synovitis of joints in JIA patients with clinically defined inactive joints. Also, it can indicate the degree of disease severity in JIA patients. So, high frequency power Doppler US can be used in standard clinical practice for monitoring JIA patients for better assessment and management of the disease.