JRA is the most common rheumatic disease in childhood Clinical evaluation of the disease is frequently
supplemented with radiological investigations. Musculoskeletal ultrasonography has considerable
advantages over other imaging methods in the diagnosis of JRA The aim of this work was to study the
ultrasonographic features of the knee and hip joints in relation to clinical measures of the JRA and their
relation to joint activity.
Patients and methods: This study included 45 patients (age ranged 4 — 12 Y) as well as 20 apparently
healthy children as a control group. All patients were subjected to full history, locomotor examination, knee
and hip uhrasonography according to standard protocol Knee synovial thickness, suprapatellar effusion and
hip synovial joint space (5.15) were measured.
Results: Filly two knees out of 90 knees and 18 hips out of 90 hips examined were clinically active,.
Knee synovial thickness had sensitivity 82.5% and specificity 95% while hip SJS had sensitivity 32.5% and
specificity 85% in the diagnosis of joint activity in JRA patients. There is significant increase in fluid volume
in suprapatellar bursa in active than in inactive knees.
Conclusion: Ultrasonography detected parameters represent a reliable index of JRA disease activity
with a higher sensitivity to ultrasonographic knee synovial thickness and a higher specificity for
ultrasonographic knee effusion. This was not much realized with the hip SJS width.
Introduction:
Juvenile Rheumatoid arthritis (JRA) is a
special form of rheumatoid arthritis which
occurs in childhood and adolescence
before the age of sixteen. It is considered
a major cause of disability.( I ) It is
primarily affects the joints but can also
cause heavy damage to organs and
systems. (2)
History and physical examination
supplemented with radiological
investigation are the usual tools to reach a
diagnosis in JRA. (3). Although previous
studies in patients with JRA have
demonstrated that MRI reveals early joint
involvement, it considered expensive, lime
consuming and subsequently not suitable
as monitoring follow up method (4)
Ultrasonography is an increasingly used
technique for the evaluation of
inflammatory joint disease (5.). It has been
shown to be sensitive in the detection of
synovitis and bone erosion in both small
and large joints. (6) It has several
advantages over MRI including cost,
immediate availability in the clinic and the
ability to scan multiple joints at the same
time. (7)
The aim of this paper was to study the
ultrasonographic features of the knee and
hip joints as a model of superficial and deep
synovial joints in relation to the clinical
measures of the JRA patients and also to
evaluate the accuracy of ultrasound in
diagnosis of local joint activity.
Patients and Methods
Forty five patients with JRA defined
according to Cassidy1989 (8)
classification criteria are referred from
pediatric department to rheumatology
and rehabilitation department in Benha
University Hospital.
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