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Pediatric Radiology

, Volume 37, Issue 5, pp 475–482 | Cite as

US findings of metacarpophalangeal joints in children with idiopathic juvenile arthritis

  • Boaz Karmazyn
  • Suzanne L. Bowyer
  • Kara Murphy Schmidt
  • Susan H. Ballinger
  • Kenneth Buckwalter
  • Thuy T. Beam
  • Jun Ying
Original Article

Abstract

Background

Juvenile idiopathic arthritis (JIA) is the most common cause of chronic arthritis in children, with frequent involvement of the metacarpophalangeal joints (MCPJ).

Objective

To compare US findings with those of radiography and clinical examination.

Materials and methods

All MCPJs in 20 children with JIA (17 females, median age 9.7 years, range 3.6 to 16.8 years) were evaluated clinically and imaged with gray-scale and color Doppler US, and 90 MCPJs were also imaged radiographically. Each MCPJ was graded on physical examination from 0 (normal) to 4 (severe) by the patient’s rheumatologist.

Results

US demonstrated abnormalities in 64 of 200 MCPJs (32.0%), including pannus vascularity and/or tenosynovitis in 55 joints (27.5%) (pannus vascularity in 43, tenosynovitis in 40) and bone destruction in 25 joints (12.5%). Overall, US abnormalities and physical examination scores were significantly associated (P < 0.001). However, interobserver agreement between US and clinical evaluation was poor (kappa 0.1) and between US and radiography was only fair (kappa 0.4).

Conclusion

US of the MCPJ in children with JIA can demonstrate cartilage thinning, bone erosions, and pannus vascularity. Abnormal US findings are significantly correlated with severity of disease as evaluated clinically.

Keywords

US Idiopathic juvenile arthritis Metacarpophalangeal joints Children 

Notes

Acknowledgements

The authors gratefully acknowledge S. Gregory Jennings for his editorial assistance and Rhonda Gerding for her secretarial assistance.

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Boaz Karmazyn
    • 1
  • Suzanne L. Bowyer
    • 3
  • Kara Murphy Schmidt
    • 3
  • Susan H. Ballinger
    • 3
  • Kenneth Buckwalter
    • 2
  • Thuy T. Beam
    • 3
  • Jun Ying
    • 4
  1. 1.RadiologyRiley Hospital for ChildrenIndianapolisUSA
  2. 2.RadiologyUniversity HospitalIndianapolisUSA
  3. 3.Pediatric RheumatologyIndiana UniversityIndianapolisUSA
  4. 4.Biostatistics, Institute for the Study of HealthUniversity of CincinnatiCincinnatiUSA

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