Article
Fluorescence optical imaging in patients with juvenile rheumatic joint diseases – A comparative study with ultrasonography
Search Medline for
Authors
-
Marisa Beck
- Deutsches Rheuma-Forschungszentrum (DRFZ), Programmbereich Epidemiologie, Berlin
-
Jens Klotsche
- Deutsches Rheuma-Forschungszentrum (DRFZ), Programmbereich Epidemiologie, Berlin
-
Anne Marie Glimm
- Charité - Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Rheumatologie und klinische Immunologie, Berlin
-
Sarah Ohrndorf
- Charité - Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Rheumatologie und klinische Immunologie, Berlin
-
Stephanie Werner
- Medizinische Klinik mit Schwerpunkt Rheumatologie u. Klinische Immunologie, Charité Universitätsmedizin Berlin, Berlin
-
Gerd Horneff
- Asklepios Klinik Sankt Augustin, Sankt Augustin
-
Marina Backhaus
- Park-Klinik Weissensee, Abteilung für Innere Medizin - Rheumatologie und Klinische Immunologie, Berlin
-
Ralf Trauzeddel
- Helios Klinikum Berlin-Buch Klinik für Kinderheilkunde- und Jugendmedizin, Kinder- und Jugendrheumatologie, Berlin
-
Kirsten Minden
- Deutsches Rheuma-Forschungszentrum (DRFZ) und Charité Universitätsmedizin Berlin, Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie, Berlin
-
Hermann Girschick
- Vivantes Klinikum im Friedrichshain, Klinik für Kinder- und Jugendmedizin, Berlin
| Published: | September 4, 2017 |
|---|
Outline
Text
Background: Valid detection of inflammation in joints is essential in differential diagnosis of joint pain. Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory rheumatic disease in childhood. Imaging techniques assist in making the right diagnosis, evaluation of treatment response and outcome assessment. Fluorescence optical imaging (FOI) is a new method that has been shown to visualize inflammation in arthritis of wrist and finger joints.
Objectives: Firstly, to determine association and agreement of FOI with ultrasonography (US) and clinical assessment of active joints. Secondly, to estimate the predictive power of FOI for discrimination between inflammatory and non-inflammatory rheumatic joint diseases.
Methods: 76 patients from three paediatric rheumatologic centres were enrolled and categorized into three groups depending on diagnosis and presence of clinical arthritis. FOI and US were performed in each patient. FOI phases (P) 1-3 and automatically generated PrimaVista mode (PVM) were interpreted separately. A semi-quantitative score (grades 0–3) was applied to both methods and joints were defined as active with scores >0, respectively.
Results: Agreement of FOI with US and clinical examination (CE) was good, with differences between groups and FOI phases. High agreement was partly due to the high number of inactive joints. Of all methods, FOI showed the highest rate of positive results. With US as reference, FOI was more sensitive for detecting synovitis than CE (67.4% vs. 42.8%). FOI was also more sensitive for detecting clinically active joints than US (75.2% vs. 58.1%). Sensitivity was consistently highest in P2 (up to 63.1%). Specificity compared to US was 64.9%, reaching highest values in PVM (88.8%) and P3 (95.7%). In patients without inflammatory joint diseases both FOI and US were oversensitive. The predictive value for discrimination between inflammatory and non-inflammatory diseases was 0.80 for FOI and 0.78 for US.
Conclusion: FOI and US had a comparable predictive power to distinguish between inflammatory and non-inflammatory rheumatic diseases in children and adolescents. Agreement between clinically active joints, US and FOI was good. Still, both imaging methods showed limitations and should be interpreted with caution. FOI may provide an additional method to evaluate inflammation of wrist and finger joints.
Acknowledgements: The study was supported by an unrestricted educational grant by Pfizer.
