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Quantitative ultrasonometry of the calcaneus in children with juvenile idiopathic arthritis
S Kutilek1, M Bayer, P Dolezalova
1Center for Clinical and Basic Research (CCBR), Kyjevská 40, 530 03 Pardubice, Czech Republic. sk@ccbr.cz
Insights
Juvenile idiopathic arthritis (JIA) in children, particularly the polyarticular form, is linked to reduced bone quality. Longer disease duration and higher prednisone doses negatively impact bone health in these patients.
Area of Science:
- Pediatric Rheumatology
- Bone Metabolism
- Quantitative Ultrasonometry
Background:
- Juvenile idiopathic arthritis (JIA) is a chronic inflammatory condition affecting children.
- Bone health is a significant concern in pediatric rheumatic diseases.
- Quantitative ultrasonometry (QUS) offers a non-invasive method to assess bone quality.
Purpose of the Study:
- To evaluate bone quality using QUS in children diagnosed with JIA.
- To compare bone quality parameters between different subtypes of JIA and reference data.
- To identify factors influencing bone quality in children with JIA.
Main Methods:
- Seventy children with JIA (oligoarticular and polyarticular RF-negative subtypes) underwent QUS measurements on both heels.
- Body height, weight, BMI, disease duration, and cumulative prednisone dose were recorded.
- QUS parameters, including broadband ultrasound attenuation (BUA) and velocity of sound (VOS), were analyzed.
Main Results:
- Children with polyarticular JIA exhibited significantly lower QUS parameters compared to reference data and oligoarticular JIA.
- Oligoarticular JIA also showed significantly lower QUS values than reference data.
- QUS parameters were influenced by body height and weight, with inverse correlations observed between QUS, disease duration, and cumulative prednisone dose in polyarticular JIA.
Conclusions:
- Disease duration and cumulative prednisone dose are identified as risk factors for impaired bone quality in children with polyarticular JIA.
- These factors may contribute to stunted growth and decreased bone mineral status.
- QUS is a valuable tool for assessing bone health in pediatric JIA patients.
Objectives:
To evaluate bone quality by means of quantitative ultrasonometry (QUS) in children with juvenile idiopathic arthritis (JIA).
Methods:
Seventy children [37 with oligoarticular JIA, mean age (+/-s.d.) 10.54 +/- 3.42 yr; and 33 with polyarticular rheumatoid factor negative JIA, mean age (+/- s.d.) 11.33 +/- 2.88 yr] were enrolled. Quantitative ultrasonometry was measured on both heels with a Cuba Clinical portable device. Body height, weight and body mass index were recorded together with disease duration and cumulative dose of prednisone.
Results:
The lowest QUS parameters were observed in children with polyarticular JIA (P< 0.001 and 0.01 when compared with reference data and oligoarticular JIA, respectively). In children with oligoarticular JIA, the QUS values were also significantly lower in comparison with the reference data (P< 0.002). The QUS parameters were strongly influenced by body height, and to a lesser degree by body weight. In children with polyarticular JIA, there were significant inverse correlations between QUS parameters and disease duration [r=-0.57, P< 0.01 for broadband ultrasound attenuation (BUA) and r = - 0.67, P< 0.01 for velocity of sound (VOS)]. Similarly, there were inverse correlations between QUS and cumulative dose of prednisone (r = - 0.48, P< 0.05 for BUA and r =- 0.50, P < 0.01 for VOS, respectively). Similar results were obtained when BUA and VOS were adjusted for height.
Conclusions:
Disease duration and cumulative dose of prednisone in children with polyarticular JIA are risk factors of stunted growth and decreased QUS values of bone quality.
