May 6, 2011

Detecting Arthritis in Kids Sooner

(Ivanhoe Newswire) -- Detecting juvenile inflammatory arthritis (JIA) may require a two-pronged approach. Sonography with power Doppler combined with physical exams may help doctors make assessments in joint activity and sub-clinical disease, according to new research. 

JIA is a potentially debilitating childhood disease. Early treatment may help children with JIA avoid long-term joint damage and disability.

Researchers from the Albert Einstein College of Medicine's Montefiore Medical Center compared sonography with Doppler to physical exams in evaluating the knees and ankles of kids with JIA.

The investigators study 84 joint in 19 patients. Of these, 65 joints were concordant on both sonography and physical exams. Of the remaining 19 joints, 14 were active on sonography and inactive on physical exams. Five of the 14 joints were identified as having subclinical disease at the time of the initial physical exam, while eight of the 14 joints showed mild hyperemia as the only indicator of disease activity on sonography, which was a false positive. Of the five joints found to be active on physical exams and inactive on sonography, four had subtalar disease.

"In patients with at least one active joint on physical examination, ultrasound augments the physical exam by identifying subclinical disease (in other joints). Our study confirmed that patients with evidence of subclinical disease do, in many cases, go on to have clinically evident disease," Vikash Panghaal, M.D., lead author of the study, was quoted as saying.

"Certain combinations of physical exam findings are highly sensitive, and in these instances, ultrasound does not contribute to clinical management. Subtalar disease is poorly assessed using ultrasound," he concluded.

SOURCE: The 2011 American Roentgen Ray Society's annual meeting