Rheumatology Medical News about JIA, Ankle, Tenosynovitis

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Ankle disease in juvenile idiopathic arthritis: Ultrasound findings in clinically swollen ankles
Journal of Rheumatology, 08/14/09

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

Results

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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