Articular sonography of juvenile idiopathic arthritis in remission: a prospective study

Abstract

Juvenile idiopathic artrhtitis (JIA) is the most common chronic rheumatic disorder of childhood. It has a variable prognosis and is characterized by flares and remissions. The physiopathology of JIA comprises an inflammatory process of the synovium and the periarticular tissues with development of synovial pannus. The synovial pannus is the most pathologic factor of cartilage and bone destruction and can result in joint ankylosis. The improvement of JIA therapy has carried out a better quality of life of patients, decreasing articular damage and increasing clinical remission rates. The preliminary criteria for inactive disease and clinical remission with or without medication are based in clinical and laboratory patterns. Previous studies in JIA that analyzed the knees, hips, interphalangeal joints of the hand and others joints with ultrasound (US) detected subclinical synovitis in patients considered as clinically inactives. It is not clear if subclinical synovitis detected by imaging techniques can predict if assintomatic joints will progress to articular damage and functional worsening. The aims of this study were to evaluate the presence of subclinical synovitis by Doppler US in patients with JIA that are in clinical remission and to determine if there is a correlation between the US findings and clinical, laboratory and functional features of this patients in baseline and at long term. (AU)