TY - JOUR T1 - Ankle Disease in Juvenile Idiopathic Arthritis: Ultrasound Findings in Clinically Swollen Ankles JF - The Journal of Rheumatology JO - J Rheumatol SP - 1725 LP - 1729 DO - 10.3899/jrheum.080508 VL - 36 IS - 8 AU - MADELEINE E. ROONEY AU - CATHERINE McALLISTER AU - JAMES F.T. BURNS Y1 - 2009/08/01 UR - http://www.jrheum.org/content/36/8/1725.abstract N2 - Objective. The ankle joint is frequently involved in juvenile idiopathic arthritis (JIA), but it is unclear whether this is predominantly due to synovitis, tenosynovitis, or both. We performed clinic-based ultrasound examination to assess the prevalence of synovitis and tenosynovitis in children with JIA felt clinically to have active inflammatory disease of the ankle. Methods. Thirty-four patients with 49 clinically swollen ankles were studied (19 polyarticular JIA, 13 oligoarticular JIA, 1 systemic JIA, 1 psoriatic JIA). All cases had at least one clinically swollen ankle joint. The children were assessed clinically and had ultrasound examination during routine clinic appointments. Results. We found 71% of ankles had tenosynovitis and 39% had tenosynovitis alone. Only 29% of swollen ankles had a tibiotalar effusion alone. We found 33% had both tenosynovitis and a tibiotalar effusion. When results were analyzed by JIA subtype, we found 81% of oligoarticular JIA ankles had medial ankle tenosynovitis but only 19% had tibiotalar effusion alone. There was a significant difference between JIA subgroups for the frequency of occurrence of medial ankle tenosynovitis (p = 0.048) and lateral ankle tenosynovitis (p = 0.001). Conclusion. The tibiotalar joint was not involved in 39% of the swollen ankles; and tenosynovitis, sometimes in isolation, was the dominant finding. This has implications for therapeutic intervention and also for an improved classification of children with JIA, especially with ankle involvement. ER -