Abstract
Although musculoskeletal ultrasound (MSUS) has emerged as an indispensible tool among physicians involved in musculoskeletal medicine in the last two decades, only recently has it become more attractive to pediatric rheumatologists. Thereafter, the use of MSUS in pediatric rheumatology has started to increase. Yet, an ever-growing body of literature shows parity and even superiority of MSUS when compared to physical examination and other imaging modalities.MSUS is suitable for examination of children of all ages and it has certain advantages over other imaging modalities; as it is cheaper, mobile, instantly accessible bedside, easy to combine with clinical assessment (interactivity) and non-invasive. It does not require sedation, which facilitates repetitive examinations. Assessment of multiple locations is possible during the same session. Agitation is rarely a problem and small children can be seated in their parents' lap or they can even play while being examined.
Highlights
Background musculoskeletal ultrasound (MSUS) has emerged as an indispensable tool among physicians involved in musculoskeletal medicine in the last two decades, only recently has it become more attractive to pediatric rheumatologists
Several noninvasive techniques have been proposed to assess articular involvement of the pediatric rheumatoid diseases; magnetic resonance imaging (MRI) and MSUS have come to the forefront
Similar to the stituation in adult rheumatoid arthritis, MSUS has proven to be valuable in the early diagnosis of Juvenile idiopathic arthritis (JIA), for evaluation and follow-up of disease activity and for the assessment of treatment response [10]
Summary
Musculoskeletal ultrasound (MSUS) has emerged as an indispensable tool among physicians involved in musculoskeletal medicine in the last two decades, only recently has it become more attractive to pediatric rheumatologists. Similar to the stituation in adult rheumatoid arthritis, MSUS has proven to be valuable in the early diagnosis of JIA, for evaluation and follow-up of disease activity and for the assessment of treatment response [10] It is exquisitely sensitive in detecting synovitis, intra-articular effusion, and cartilage edema/thinning or bony erosions [11,12]. In line with previous literature concerning rheumatoid arthritis, recent studies on JIA confirmed that MSUS is equal or superior to plain radiography in detecting cortical erosions in sonographically accessible areas, but that it is less reliable in detecting intramedullary lesions and those within the centres of larger joints, due to the acoustic shadowing from overlying bones [6,28,33]. Other recent advances include new technologies that combined with MRI and high-intensity focused ultrasound for confirmative diagnosis [45]
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