Role of Musculoskeletal Ultrasound in the Assessment of Juvenile Idiopathic Arthritis: A Systematic Review

Abstract

Overview of Juvenile Idiopathic Arthritis Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood. JIA is a serious autoimmune disease that can cause permanent joint damage and loss of function leading to marked disability. So early detection is very important and considers life saving. The ILAR sub-classified the disease into seven categories: They are systemic, oligoarticular (persistent and extended), polyarticular (RF+,RF-), psoriatic, enthesitis-related arthritis and undifferentiated. Technical aspect of musculoskeletal ultrasound Musculoskeletal ultrasound uses multi-frequency probes, different frequencies are chosen based on joint size. MSUS imaging requires a high-resolution image and the linear transducers are preferred with frequencies between 15 MHz and 18 MHz but hockey stick transducer allows better angulations in small joints to reducing risk of artifacts MSUS usually performed using B-mode or grayscale US. In addition, color doppler or power doppler can be used in the assessment in detecting inflammation

Role of US in JIA Standardized MSUS technique: components of the pediatric joint detected by US: hyaline cartilage, epiphyseal secondary ossification centre ,joint capsule , synovial membrane , ossified portion of epiphysis ,physiological vascularity and fat pad US is sensitive and more accurate than clinical examination in detecting synovitis, tenosynovitis and enthesitis.