PMID- 21312344
OWN - NLM
STAT- MEDLINE
DCOM- 20110802
LR  - 20220309
IS  - 2151-4658 (Electronic)
IS  - 2151-464X (Linking)
VI  - 63
IP  - 6
DP  - 2011 Jun
TI  - Ultrasonography for detecting enthesitis in juvenile idiopathic arthritis.
PG  - 849-55
LID - 10.1002/acr.20444 [doi]
AB  - OBJECTIVE: Enthesitis is a major feature of juvenile idiopathic arthritis (JIA) 
      but is difficult to diagnose clinically. Our objective was to compare the 
      accuracy of ultrasonography with power Doppler (US-PD) versus clinical 
      examination for diagnosing enthesitis in patients with JIA and healthy controls. 
      METHODS: Twenty-six consecutive patients with JIA and 41 healthy volunteers 
      underwent standardized clinical and US-PD examinations of 5 entheseal sites 
      (proximal and distal quadricepital tendon insertions, Achilles tendon, and 
      plantar fascia). US-PD reproducibility was evaluated. US-PD enthesitis was 
      defined as a PD signal at the enthesis insertion. Bursitis, erosions, and 
      cartilage vascularization were recorded. RESULTS: In the JIA group, 27 (12.5%) of 
      the entheseal sites exhibited clinical enthesitis (distal patellar ligament in 
      45% of cases) and 20 (9.4%) exhibited US-PD enthesitis (distal patellar tendon in 
      30%), including 10 clinically normal sites (50%). US-PD enthesitis was found in 
      several patients with oligoarthritis or polyarthritis. Clinical enthesitis (P < 
      0.0001) and HLA-B27-positive (P = 0.05) status were significantly associated with 
      US-PD enthesitis. Erosion and bursitis, but not tendon thickening, were 
      associated with US-PD enthesitis. US-PD enthesitis was not found at any of the 
      410 entheseal sites in controls; grade 1 cartilage vascularization was noted at 
      6% of the control sites. CONCLUSION: Enthesitis is a rare phenomenon in JIA. 
      Clinically silent enthesitis is detected by US-PD and can be found in JIA 
      categories other than enthesitis-related arthritis. Tendon thickening and 
      cartilage vascularization can be detected in healthy controls. These findings may 
      have implications for patient classification of the use of US-PD.
CI  - Copyright (c) 2011 by the American College of Rheumatology.
FAU - Jousse-Joulin, Sandrine
AU  - Jousse-Joulin S
AD  - Centre Hospitalier Universitaire Brest and Universite de Bretagne Occidentale, 
      Brest, France.
FAU - Breton, Sylvain
AU  - Breton S
FAU - Cangemi, Claire
AU  - Cangemi C
FAU - Fenoll, Bertrand
AU  - Fenoll B
FAU - Bressolette, Luc
AU  - Bressolette L
FAU - de Parscau, Loic
AU  - de Parscau L
FAU - Saraux, Alain
AU  - Saraux A
FAU - Devauchelle-Pensec, Valerie
AU  - Devauchelle-Pensec V
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Arthritis Care Res (Hoboken)
JT  - Arthritis care & research
JID - 101518086
SB  - IM
MH  - Adolescent
MH  - Arthritis, Juvenile/blood/complications/*diagnostic imaging
MH  - Child
MH  - Female
MH  - Humans
MH  - Male
MH  - Rheumatic Diseases/blood/complications/diagnostic imaging
MH  - Tendinopathy/blood/complications/*diagnostic imaging
MH  - Ultrasonography, Doppler/methods
EDAT- 2011/02/12 06:00
MHDA- 2011/08/04 06:00
CRDT- 2011/02/12 06:00
PHST- 2011/02/12 06:00 [entrez]
PHST- 2011/02/12 06:00 [pubmed]
PHST- 2011/08/04 06:00 [medline]
AID - 10.1002/acr.20444 [doi]
PST - ppublish
SO  - Arthritis Care Res (Hoboken). 2011 Jun;63(6):849-55. doi: 10.1002/acr.20444.