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Ankle disease in juvenile idiopathic arthritis: Ultrasound findings in clinically swollen ankles
Journal of Rheumatology, 08/17/09
Rooney ME et al. – Findings show that tibiotalar joint was not involved in 39% of the swollen ankles in children with juvenile idiopathic arthritis (JIA); and tenosynovitis, sometimes in isolation, was the dominant finding. This has implications for therapeutic intervention and also for an improved classification of children with JIA, especially with ankle involvement.
Methods- Study aims to investigate whether the ankle joint involvement is predominantly due to synovitis, tenosynovitis, or both in children with JIA
- A clinic-based ultrasound examination to assess the prevalence of synovitis and tenosynovitis in pts felt clinically to have active inflammatory disease of the ankle
- 34 pts with 49 clinically swollen ankles were studied:
- 19 polyarticular JIA
- 13 oligoarticular JIA
- 1 systemic JIA
- 1 psoriatic JIA
- All cases had at least one clinically swollen ankle joint
- Children were assessed clinically and had ultrasound examination during routine clinic appointments
- 71% of ankles had tenosynovitis and 39% had tenosynovitis alone
- Only 29% of swollen ankles had a tibiotalar effusion alone
- 33% had both tenosynovitis and a tibiotalar effusion
- When results were analyzed by JIA subtype:
- 81% of oligoarticular JIA ankles had medial ankle tenosynovitis
- But only 19% had tibiotalar effusion alone
- A significant difference between JIA subgroups for the frequency of occurrence of medial and lateral ankle tenosynovitis was found
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