ORIGINAL ARTICLEUltrasound versus MRI in the evaluation of juvenile idiopathic arthritis of the knee
Section snippets
Patients and methods
Thirty-eight patients with JIA who had clinical signs of knee joint involvement were consecutively gathered from those attending outpatient rheumatology clinics, Ain Shams University Hospitals. All patients met the International League of Associations for Rheumatology (ILAR) criteria for the diagnosis of juvenile idiopathic arthritis (Durban 1997) 〚10〛. They were 25 girls and 13 boys aged 2–17 years (mean 8 years), with the onset of JIA before the age of 16 and a disease duration of at least 6
Results
Acute synovitis in at least one knee joint was present in 15/38 (39.5%) of patients, while chronic synovitis was evident in the rest of the patients 23/38 (60.5%). Table I shows patterns of arthritis included in this study and their characteristic lab results. Table II presents the different clinical presentations of the 38 patients encountered in our study.
By US examination synovial proliferation (pannus) was detected in 18/38 cases; it appeared as a hypoechoic or heterogenous thickening of
Discussion
Juvenile idiopathic arthritis is a chronic collagen disease with variable multisystem manifestations. Most children with JIA develop symptoms at or about the age of 4–7 years 〚12〛. The knee was found to be the most commonly affected joint in JIA and in many ways accounts for the most disability 〚2〛. Acute synovitis that becomes chronic leads to synovial proliferation and the formation of highly cellular pannus that erodes bone at the osteochondral junction, invades marrow space, undermines
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