Ultrasonography in early diagnosis of 1' Hip involvement in Juvenile Rheumatoid Arthritis (JRA)

Abstract

Hip joint involvemmt in JRA is a poor prognoc fuctor, since the hip is a weight-bearing joint in 1lich anatomical defoJtnities can cause serious disabilities.In the g1mvth phase ,tl-.e htnnan skeleton is composro lrugely of cartilage whicl1 is not visible in com-entional radio<§l!Phs,making evaluation of progressive cl1a11ges ruch as loss of cartilage or joint space or the presence ofjoint ef!Usion difiirult.ln conventional mdio<gaphs joint ef!Usion is recognisro primarily tl1100gh displacement of tl-.e fut planes adjacem to tl-.e joint,\\1Jile it can be early diagnosOO in elbows ruld knees ,efii.L<:ion of the hip joint not possble due to tl-.e ante ior localisation of the fut planes. 77reaim t!ft!tiv 11vrl1was to evaluate tl-.e usefuh-.ess of ultrnsonography as a non-invasive ted111ique in in detection of early alteration ofhip joint disea..<.e in patie111S with JRAlllirty dlildren ruflering from JRA comprisro tl-.e material of this 'VO!k.Ten d1ildre:n fi-eeofsign.<1symptoms related to rheumatic diseases Wele chosen as a control group.AII patie!liS Wele examined clinically,laboratory investigated ,X-ray shooted, ruld ultra9Jlmd imaged on ll1e hip joint.77re=ttlt•oofour Study shO\ved that ultra'Uillld can detect ef!Usion and!orsynovitis in a clinically silent hip jointHqJ joint pain is an early sign to hip involvement while limited hip joint movement is a rure sign.Piain X-ray is not a reliable rretllOd fur tl-.e early detection of hip involvment in JRA . ll1ere was no rleed to correlate tile labordlory data between patie!liS with hip effusion ru1d t110se with01.tt as tl-.ese data are not specific to!lip joint invohement alone ru1d may point to other jointinvolvment.Umdu.liou :Fmmtllisstudy\vecruJ-.etot!Je conclusion tllal ultrnsonography cru1 be considered a rapid ,non ill\•asive, economical, ruld reliable nJetllOd for tl-.e early detection ofhip joint involvement in JRA.