TY - JOUR T1 - Ultrasound and Cartilage Thickness in Juvenile Idiopathic Arthritis: New Findings, New Questions JF - The Journal of Rheumatology JO - J Rheumatol SP - 1466 LP - 1468 DO - 10.3899/jrheum.130737 VL - 40 IS - 9 AU - GINGER JANOW AU - NORMAN T. ILOWITE Y1 - 2013/09/01 UR - http://www.jrheum.org/content/40/9/1466.abstract N2 - In recent years, ultrasound (US) has emerged as a potentially powerful tool for diagnosis and assessment in juvenile idiopathic arthritis (JIA). US with power Doppler (PD) can identify joint effusions, synovial hypertrophy, and increased vascularity, all of which suggest active synovitis. Chronic disease is demonstrated by structural joint damage, including erosions and cartilage thinning. These findings have been considered important markers for disease progression, and they can influence management. Current treatment paradigms aim to avoid reaching the point of structural damage; thus much of the focus of US in JIA has been on identifying active inflammation and subclinical disease1. Studies have suggested that US may be more sensitive for identifying active disease than physical examination1,2.The role of US in detecting structural damage in children, specifically cartilage loss, is complicated by the normal ossification process in the developing skeleton. Interpreting cartilage measurements requires an understanding of the variations in cartilage thickness based on age and sex. Spannow, et al have been at the forefront of establishing age- and sex-specific normal values for cartilage thickness over the past several years. Their initial study in 2009 assessed intrarater and interrater reliability when measuring cartilage thickness in children by US3. In 2010, they looked at a large cohort of 394 normal children and developed sex- and age-related normal values for cartilage thickness4. The finding that normal values varied by sex and age was … Address correspondence to Dr. Janow; E-mail: gjanow{at}hackensackumc.org ER -