The high sensitivity of arthrosonography in imaging changes in hip and knee joints of juvenile rheumatoid arthritis (JRA) patients has been confirmed in a study by investigators in Germany. Sonographic effusion of the knee provided the highest correlation with measures of clinical disease activity in this study, report Dr M Frosch and colleagues from the University of Muenster, Muenster and Northwest German Centre of Rheumatology, Sendenhorst. At intervals of from four to six weeks and on three separate occasions, these researchers examined 28 JRA patients with active disease at study entry in 15 hips and 38 knee joints.
They documented sonographic, clinical and laboratory findings at the same time in both clinically active and inactive disease. Ten children with no history of arthritis were examined by ultrasound to serve as controls on sonographic variables.
Overall, in active arthritis of the hip joint, 19 of 31 (61%) examinations showed a pathological widening of the synovial joint space. Although there was no significant correlation between sonographic and clinical measures of disease activity in coxitis, there was marked effusion within the suprapatellar pouch in 87% and thickening of the synovial membrane in 92% of cases of active gonarthritis in JRA patients….
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