Toward Standardized Ultrasound Measurements of Cartilage Thickness in Children: Figure 1.

Abstract

In the past decade, musculoskeletal ultrasound (US) has become well established as a diagnostic method in adult rheumatology. B-mode (or greyscale) US has been shown to be an excellent tool, equally as effective as magnetic resonance imaging (MRI), to assess joint effusions and synovial thickening1. Power Doppler US detects slow flow in small vessels, which is part of the pathological process in synovitis2. In addition, cartilage thickness can be assessed with US3. As one of the cardinal features of inflammatory arthritis is cartilage loss, and joint space narrowing is increasingly recognized as a factor in work disability and poor quality of life4, US might play an important role in the monitoring of patients with chronic arthritis. The clinical utility of musculoskeletal US is likely to be at least as important in pediatric rheumatology as it is in adult rheumatology. The longterm consequences of insufficiently treated and therefore persistently active juvenile arthritis are enormous given the young age of the patients5, and a recent review has outlined the impact on health related quality of life, physical function, and visual outcome6. The exact assessment of joint disease activity as well as the assessment of joint damage in the form of cartilage loss is therefore very important and has become ever more crucial with improvements in treatment. The induction of permanent remission is now possible for an increasing percentage of children but cannot always be reliably demonstrated on clinical examination alone7 … Address correspondence to Dr. Larché. E-mail: mlarche{at}mcmaster.ca