Do patients with juvenile idiopathic arthritis in remission exhibit active synovitis on joint ultrasound?

Do patients with juvenile idiopathic arthritis in remission exhibit active synovitis on joint ultrasound?

Author Miotto e Silva, Vanessa Bugni Autor UNIFESP Google Scholar
Tavares da Silva, Carolina de Freitas Autor UNIFESP Google Scholar
Vilela Mitraud, Sonia de Aguiar Autor UNIFESP Google Scholar
Vilar Furtado, Rita Nely Autor UNIFESP Google Scholar
Esteves Hilario, Maria Odete Autor UNIFESP Google Scholar
Natour, Jamil Autor UNIFESP Google Scholar
Terreri, Maria Teresa Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract The aim of the study was to assess the presence and characteristics of subclinical synovitis using power Doppler (PD) ultrasonography on patients with juvenile idiopathic arthritis (JIA) in clinical remission and compare the findings with those of healthy children. A cross-sectional study was carried out involving the clinical (physical exam, functional capacity and laboratory tests) and ultrasonography evaluation of 34 joints (synovial fluid/hypertrophy, PD signal and bone erosion). Subclinical synovitis was defined as the presence of synovial hypertrophy/joint effusion with or without any PD signal. Thirty-six patients (11.5 +/- A 3.74 years) and 36 controls (sex and age matched) were evaluated (2,448 joints). Twenty-seven patients were in remission on medication (mean duration: 1.8 +/- A 2.2 years). Subclinical synovitis was detected in 41.7 % patients and 11.1 % controls (p = 0.003). Erosion was detected in three patients (8.3 %). Subclinical synovitis was found in 38/1,224 (3.1 %) joints in the patients (most affected: radiocarpal wrist, anterior elbow and tibiotalar ankle) and 8/1,224 (0.6 %) joints in the controls (most affected: radiocarpal wrist). Differences in subclinical synovitis between patients and controls were found in the elbows (p = 0.033) and ankles (p = 0.006). A greater frequency of subclinical synovitis was found in patients with the extended oligoarticular or polyarticular subtypes (p = 0.013), those at an older age at disease onset (p = 0.007) and using methotrexate (p = 0.049). Patients with JIA in remission exhibit subclinical synovitis more frequently than controls. Subclinical synovitis was more frequent in patients with the polyarticular involvement and those at an older age at disease onset.
Keywords Juvenile idiopathic arthritis
Synovitis
Doppler ultrasound
Child
Remission induction
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Grant number FAPESP: 2010/50128-5
Date 2014-07-01
Published in Rheumatology International. Heidelberg: Springer Heidelberg, v. 34, n. 7, p. 937-945, 2014.
ISSN 0172-8172 (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 937-945
Origin http://dx.doi.org/10.1007/s00296-013-2909-7
Access rights Closed access
Type Article
Web of Science ID WOS:000338332300006
URI http://repositorio.unifesp.br/handle/11600/37923

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