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Evaluation of Periarticular Soft Tissues in Patients With Juvenile Idiopathic Arthritis by Superb Microvascular
Ömer Faruk Ünal1, Zuhal BayramoĞlu1, İbrahim Adaletlİ1
1Department of Radiology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.
Insights
Superb microvascular imaging (SMI) and power Doppler (PD) ultrasound revealed increased vascularity in children with juvenile idiopathic arthritis (JIA). Shear wave elastography (SWE) did not show significant elasticity differences in these pediatric patients.
Area of Science:
- Pediatric Rheumatology
- Medical Imaging
- Musculoskeletal Ultrasound
Background:
- Juvenile idiopathic arthritis (JIA) can affect periarticular soft tissues.
- Assessing soft tissue changes in JIA requires advanced imaging techniques.
Purpose of the Study:
- To compare vascularity and elasticity of periarticular soft tissues in children with JIA versus healthy controls.
- To evaluate the efficacy of superb microvascular imaging (SMI), power Doppler (PD) ultrasound, and shear wave elastography (SWE) in differentiating JIA patients.
Main Methods:
- Prospective study involving 22 children with JIA and 24 healthy controls.
- Vascularity Index (VI) assessed using SMI and PD ultrasound.
- Elasticity of quadriceps tendon (QT), patellar tendon (PT), and surrounding soft tissues measured with SWE.
Main Results:
- Significantly higher mean VI in supraarticular and infraarticular soft tissues for JIA patients compared to controls using both SMI and PD (p<0.001).
- Strong positive correlation between VI values obtained by SMI and PD (r=0.9, p=0.001).
- Moderate positive correlations found between QT/PT elasticity and supra/infraarticular soft tissue VI by SMI.
Conclusions:
- SMI and PD ultrasound can effectively differentiate children with JIA from healthy individuals based on soft tissue vascularity.
- SWE did not reveal significant differences in tendon and soft tissue elasticity between JIA patients and controls.
Objectives:
This study aims to compare the vascularity and elasticity of periarticular soft tissues by superb microvascular imaging (SMI) and power Doppler (PD) ultrasound along with shear wave elastography (SWE) between children with juvenile idiopathic arthritis (JIA) and healthy children.
Patients And Methods:
This prospective single center study, conducted between March 2018 and May 2018, included 22 children with JIA (14 males, 8 females; mean age 11.27±5 years; range, 5 to 17 years) and 24 healthy pediatric volunteers (12 males, 12 females; mean age 13±5.5 years; range, 7 to 17 years). Quadriceps tendon (QT), patellar tendon (PT), infraarticular and supraarticular soft tissue elasticities were calculated via SWE. Supraarticular and infraarticular soft tissue vascularity index (VI) were evaluated via SMI and PD.
Results:
No significant difference was found among the mean ages of the participants in study and control groups. Mean VI of both supraarticular (8.15%) and infraarticular soft tissues (7.9%) by SMI were significantly higher in study group compared to control group (2.88% vs. 2.57%, respectively). Mean VI of both supraarticular (9.1%) and infraarticular soft tissues (8.12%) by PD were significantly higher in study group compared to control group (3.4% vs. 3.1%, respectively). Highly significant good positive correlation was found between VI values obtained with PD and SMI (r=0.9, p=0.001). There was a significant moderate positive correlation between the mean elasticity of the QT with VI of the supraarticular soft tissues by SMI (r=0.4, p=0.003). There was a significant moderate positive correlation of VI of infraarticular soft tissues by SMI with mean elasiticity of PT (r=0.42, p=0.002).
Conclusion:
Vascularity index by SMI and PD could differentiate patients with JIA from healthy subjects. The SWE examination of tendons and soft tissues did not show any significant difference among patients with JIA and healthy subjects.
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