The Detection Of Lesions In Joints By Musculoskeletal Ultrasound In Juvenile Idiopathic Arthritis:a Pilot Study

PARTⅠ ULTRASOUND MEASUREMENTS OF CARTILAGE THICKNESS OF HEALTHY CHILDREN IN DIFFERENT AGESObjective: To establish normal standard reference values of epiphyseal cartilage and jiont cartilage thickness of children in different ages, and offer the basis of assessing the early change in epiphyseal cartilage and jiont cartilage of JIA with ultrasound.Methods: Epiphyseal cartilage and jiont cartilage thickness were measured in 503 healthy children, including 336 boys and 167 girls. They were divided into 4 groups:children’s group(1-to 3- year-old,n=120),preschool group(3-to 6- year-old,n=136),school-age group(6-to 10-year-old,n=124),adolescence group(10-to 16- year-old,n=123).Bilateral epiphyseal cartilage and jiont cartilage thickness of the elbow,wrist,second metacarpophalangeal( MCP2), third metacarpophalangeal(MCP3),hip,knee and ankle joints were measured.Results: Cartilage thickness was shown significantly difference between sexes and between ages(P<0.05 for all joints),boys had thicker cartilage than girls at the same ages. A linear relationship was between cartilage thickness and age, and cartilage thickness decreased with increasing age in both sexes. There was no difference between the right and left side of all the investigated joints(P>0.05).Conclusion: We established normal standard reference values for epiphyseal cartilage and jiont cartilage thickness of the elbow, wrist,MCP2,MCP3,hip,knee and ankle joints in different aged-children.PARTⅡ THE DETECTION OF LESIONS IN JOINTS BY MUSCULOSKELETAL ULTRASOUND IN JUVENILE IDIOPATHIC ARTHRITIS:A PILOT STUDYObjective: To exploring the value of the detection of changes in joints by musculoskeletal ultrasound in juvenile idiopathic arthritis(JIA).Methods: Seventy-four patients with JIA was examined in the same standardized by high frequency and power Doppler ultrasound.Twenty-first joints were evaluated bilaterally,including glenohumerals,elbows, wrists,first to fifth metacarpophalangeal joints(MCP1-5) and first to fifth proximal interphalangeal joints(PIP1-5) of the hands,hips, knees,ankles,first to fifth metatarsophalangeal joints(MTP1-5). The information of physical examination and MRI examination in Seventy-four patients with JIA was recorded,at the same time.Results: Of 74 JIA patients was examined,37(50%) had at least one joint with swelling, pain or motion limitation,69(93.24%) had abnormal finding by ultrasound,including joint effusion(55 JIA patients,74.32%),tendon changes(46 JIA patients,62.16%),Synovial hypertrophy(38 JIA patients,51.35%), Synovial vascularization by power Doppler ultrasound(25 JIA patients,33.78%),Cartilage erosions(8 JIA patients,10.81%),bone erosions(4 JIA patients,5.41%),and bursal synovitis(2 JIA patients,2.70%).Of 31 joints was examined by ultrasound and MRI,only two joints examined by ultrasound were not agreement with the result of MRI examination.Conclusion: musculoskeletal ultrasound is highly sensitive for detecting lesions in joints with JIA,and can be used as the first choice for clinician to evaluating the lesions.