Comparison between clinical and ultrasound assessment of the ankle region in juvenile idiopathic #arthritis

To compare frequency of joint and tendon disease on ultrasound (US) and clinical examination (CE), and to investigate agreement between US and CE in ankles with clinically active juvenile idiopathic arthritis (JIA)..

..A total of 163 joints in 89 ankles had active synovitis on US. The tibiotalar joint (TTJ) was the most commonly affected joint on US and on CE. The intertarsalโ€joint (ITJ) and the subtalar joint (STJ) were the second in frequency on US and on CE, respectively.

Tenosynovitis was found more commonly on US than on CE (70.5% and 32.4%, respectively), and was more frequent in the medial and lateral than in the anterior tendon compartment. Isolated tenosynovitis was detected on US in 12/105 ankles. Agreement between US and CE for detection of active synovitis and tenosynovitis was less than acceptable (k<0.4). No correlation was found between any feature of active disease recorded on CE (joint swelling, tenderness/pain on motion and restricted motion) and active synovitis on US in the TTJ, STJ and ITJ.

Coupling CE with US aids to localize correctly pathology. US training of practitioners is recommended to manage ankle disease in JIA.