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Ultrasonography and color Doppler in juvenile idiopathic arthritis: diagnosis and follow-up of ultrasound-guided steroid injection in the wrist region. A descriptive interventional study

Laurell, Louise LU ; Court-Payen, Michel; Nielsen, Susan; Zak, Marek and Fasth, Anders (2012) In Pediatric Rheumatology 10.
Abstract
Background: The wrist region is one of the most complex joints of the human body. It is prone to deformity and functional impairment in juvenile idiopathic arthritis (JIA), and is difficult to examine clinically. The aim of this study was to evaluate the role of ultrasonography (US) with Doppler in diagnosis of synovitis, guidance of steroid injections, and follow-up examinations of the wrist in JIA. Methods: In 11 patients (median age 12.5 years, range 2-16), 15 wrists with clinically active arthritis were assessed clinically by US and color Doppler (Logiq 9, GE, 16-4 MHz linear transducer) prior to and 1 and 4 weeks after US-guided steroid injection. Results: US detected synovitis in the radio-carpal joints, the midcarpal joints, and the... (More)
Background: The wrist region is one of the most complex joints of the human body. It is prone to deformity and functional impairment in juvenile idiopathic arthritis (JIA), and is difficult to examine clinically. The aim of this study was to evaluate the role of ultrasonography (US) with Doppler in diagnosis of synovitis, guidance of steroid injections, and follow-up examinations of the wrist in JIA. Methods: In 11 patients (median age 12.5 years, range 2-16), 15 wrists with clinically active arthritis were assessed clinically by US and color Doppler (Logiq 9, GE, 16-4 MHz linear transducer) prior to and 1 and 4 weeks after US-guided steroid injection. Results: US detected synovitis in the radio-carpal joints, the midcarpal joints, and the tendon sheaths in 87%, 53% and 33% of the wrists, respectively. Multiple compartments were involved in 67%. US-guidance allowed accurate placement of steroid in all 21 injected compartments, with a low rate of subcutaneous atrophy. Synovial hypertrophy was normalized in 86% of the wrists, hyperemia in 91%, and clinically active arthritis in 80%. Conclusions: US enabled detection of synovial inflammation in compartments that are difficult to evaluate clinically and exact guidance of injections, and it was valuable for follow-up examinations. Normalization of synovitis was achieved in most cases, which supports the notion that US is an important tool in management of wrist involvement in JIA. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Ultrasonography, Color Doppler, Juvenile idiopathic arthritis, US-guided, steroid injection, Wrist
in
Pediatric Rheumatology
volume
10
publisher
BioMed Central
external identifiers
  • wos:000304055800001
  • scopus:84859913391
ISSN
1546-0096
DOI
10.1186/1546-0096-10-11
language
English
LU publication?
yes
id
37fc114e-f627-4a38-8c47-5904e84cb5d2 (old id 2813073)
date added to LUP
2012-07-03 10:26:47
date last changed
2017-11-05 04:01:41
@article{37fc114e-f627-4a38-8c47-5904e84cb5d2,
  abstract     = {Background: The wrist region is one of the most complex joints of the human body. It is prone to deformity and functional impairment in juvenile idiopathic arthritis (JIA), and is difficult to examine clinically. The aim of this study was to evaluate the role of ultrasonography (US) with Doppler in diagnosis of synovitis, guidance of steroid injections, and follow-up examinations of the wrist in JIA. Methods: In 11 patients (median age 12.5 years, range 2-16), 15 wrists with clinically active arthritis were assessed clinically by US and color Doppler (Logiq 9, GE, 16-4 MHz linear transducer) prior to and 1 and 4 weeks after US-guided steroid injection. Results: US detected synovitis in the radio-carpal joints, the midcarpal joints, and the tendon sheaths in 87%, 53% and 33% of the wrists, respectively. Multiple compartments were involved in 67%. US-guidance allowed accurate placement of steroid in all 21 injected compartments, with a low rate of subcutaneous atrophy. Synovial hypertrophy was normalized in 86% of the wrists, hyperemia in 91%, and clinically active arthritis in 80%. Conclusions: US enabled detection of synovial inflammation in compartments that are difficult to evaluate clinically and exact guidance of injections, and it was valuable for follow-up examinations. Normalization of synovitis was achieved in most cases, which supports the notion that US is an important tool in management of wrist involvement in JIA.},
  author       = {Laurell, Louise and Court-Payen, Michel and Nielsen, Susan and Zak, Marek and Fasth, Anders},
  issn         = {1546-0096},
  keyword      = {Ultrasonography,Color Doppler,Juvenile idiopathic arthritis,US-guided,steroid injection,Wrist},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {Pediatric Rheumatology},
  title        = {Ultrasonography and color Doppler in juvenile idiopathic arthritis: diagnosis and follow-up of ultrasound-guided steroid injection in the wrist region. A descriptive interventional study},
  url          = {http://dx.doi.org/10.1186/1546-0096-10-11},
  volume       = {10},
  year         = {2012},
}