Is ultrasound a validated imaging tool for the diagnosis and management of synovitis in juvenile idiopathic arthritis? A systematic literature review
Arthritis Care & Research , 05/01/2012
Collado P et al. – Ultrasound is a valuable tool for detecting synovitis in juvenile idiopathic arthritis (JIA), and demonstrated higher sensitivity in assessing synovitis as compared to clinical examination. However, further studies are needed for evaluting the reliability and responsiveness to assess synovitis changes over the time.Methods
- A systematic literature search in EMBase and PubMed was performed before February 25th 2011.
- Selection criteria: original articles published in English language children, JIA, ultrasound, Doppler, synovitis and management.
- Data were extracted from the articles meeting the inclusion criteria, particularly focused on ultrasound definition of synovitis, scoring systems used and the metric properties studied.
- The type and number of joints tested, study design and the quality of the studies were assessed.
- Twenty studies were identified using ultrasound to assess synovitis in JIA.
- The knee was the joint most commonly studied in these articles.
- There was heterogeneity regarding ultrasound definition and quantification of synovitis.
- Synovitis was commonly assed by using grey–scale and only few studies included Doppler technique.
- Construct validity was reported in 80% of articles, including the clinical examination as the main comparator.
- Ultrasound demonstrated higher sensitivity in detecting synovitis as compared to clinical examination.
- Few studies reported ultrasound reliability and responsiveness in JIA.