PT - JOURNAL ARTICLE AU - Yongdong Zhao AU - Nanci E. Rascoff AU - Ramesh S. Iyer AU - Mahesh Thapa AU - Lucas Reichley AU - Assaf P. Oron AU - Carol A. Wallace TI - Flares of Disease in Children with Clinically Inactive Juvenile Idiopathic Arthritis Were Not Correlated with Ultrasound Findings AID - 10.3899/jrheum.170681 DP - 2018 Apr 01 TA - The Journal of Rheumatology PG - jrheum.170681 4099 - http://www.jrheum.org/content/early/2018/03/26/jrheum.170681.short 4100 - http://www.jrheum.org/content/early/2018/03/26/jrheum.170681.full AB - Objective The validity of our current definitions for clinically inactive disease (CID) in juvenile idiopathic arthritis (JIA) based on physical examination is challenged by the development of advanced musculoskeletal imaging tools. We aimed to prospectively determine the prevalence of abnormal ultrasound (US) findings in children with CID in JIA and their clinical significance. Methods Children aged ≥ 4 years with CID and a history of arthritis from a single tertiary center were approached over 1 year. Standard US of knees, tibiotalar joints, subtalar joints, and wrists were performed at baseline and at a followup visit. US images were scored by 2 pediatric musculoskeletal radiologists. Results Forty children with CID were enrolled and followed clinically. The median duration of inactive disease was 1 year. The most common International League of Associations for Rheumatology JIA categories were extended oligoarticular JIA (30%) and rheumatoid factor–negative polyarthritis (38%). At baseline, among a total of 289 joints scanned, 24 joints (8%) had at least 1 abnormal finding in 18 (45%) of 40 subjects. When evaluated at the individual joint level against flares identified during followup exams, these baseline US findings had a sensitivity of 15% and a positive predictive value of 12%. The predictive performance of the second US was even less. Conclusion Our study demonstrates that nearly half of children with CID had abnormal US findings in 1 of 8 commonly affected joints. These findings did not correlate with subsequent clinical flares in up to 2 years of followup.