Artikel
Development of an optimal ultrasound image acquisition protocol for pediatric knee arthritis – an international multicenter study by the imaging working groups of the PReS and GKJR
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Autoren
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Daniel Windschall
- Klinik für Kinder- und Jugendrheumatologie, St. Josef-Stift Sendenhorst, Sendenhorst; Medizinische Fakultät, Universität Halle-Wittenberg, Halle (Saale)
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Ralf Trauzeddel
- Helios Klinikum Berlin-Buch, Kinderrheumatologie, Berlin
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Faekah Gohar
- Klinik für Kinder- und Jugendrheumatologie, St-Josef Stift Sendenhorst, Sendenhorst
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Sebastian Schua
- Klinik für Kinder- und Jugendrheumatologie, St-Josef Stift Sendenhorst, Sendenhorst
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Sven Hardt
- Klinik für Kinder- und Jugendrheumatologie, St-Josef Stift Sendenhorst, Sendenhorst
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Manuela Krumrey-Langkammmerer
- Deutsches Zentrum für Kinder- und Jugendrheumatologie, Garmisch-Partenkirchen
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Lampros Fotis
- Private Practice Pediatric Rheumatologist, Athina
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Rainer Berendes
- Kinderkrankenhaus Sankt Marien, Landshut
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Maria Haller
- Kinder- und Jugendarztpraxis, Gundelfingen
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Hatice Dundar
- İzmir University of Economics, Faculty of Medicine, İzmir
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Silvia Magni-Manzoni
- Pädiatrisches Krankenhaus Bambino Gesù, Roma
| Veröffentlicht: | 31. August 2022 |
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Gliederung
Text
Background: Normal data describing physiological findings in paediatric knee joint ultrasound (US) has been published by the Imaging Working Groups of the GKJR and OMERACT. In practice, US B-Mode (BM) and Doppler Mode (e.g. Power Doppler, PD) can discriminate normal and pathological findings, identifying joint effusion, synovial proliferation and hypervascularization in patients with juvenile idiopathic arthritis (JIA). Different but unvalidated US views and protocols to determine arthritis have been published. Our objective was to compare pathological Doppler and B-Mode data of patients with JIA and normal findings and to evaluate the most sensitive US- acquisition protocol to diagnose knee joint synovitis.
Methods: Consenting patients aged < 18 years attending with clinical arthritis of 1 or both knee joints in 8 participating centres were included. Standardized US examination was performed using a linear transducer. BM and PD findings were graded 0 (normal)-3 (severe) according to the pediatric OMERACT-US score. Data of 203 individual knee joints was collected and analysed.
Results: A total of 203 individual knee joints were examined. Knees without arthritis were included as controls. In BM the most commonly used anterior longitudinal and transverse standard views remained the most sensitive views for assessing effusion and synovial hypertrophy, independent of whether performed in 30° flexion or neutral. However, PD in lateral transverse, lateral longitudinal and medial transverse views were more sensitive than the typically evaluated suprapatellar view. 14 patients (7%) would have been overlooked without the newly defined US views.
Conclusion: Our findings identified an optimal US acquisition protocol based on standard views and newly defined views for the reliable detection of knee arthritis in children. Ultrasound using a standardized protocol can discriminate safely between normal and pathological findings.
