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Comprehensive and reliable sonographic assessment and scoring system for inflammatory lesions of the paediatric ankle

Patricia Vega-Fernandez1, Deirdre De Ranieri2, Edward Oberle3

  • 1Division of Rheumatology, Department of Pediatrics, University of Cincinnati, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Rheumatology (Oxford, England)
|October 29, 2022
PubMed

Insights

A new ultrasound (US) protocol and scoring system were developed for assessing paediatric ankle synovitis and tenosynovitis. This reliable bedside tool aids clinical decision-making in juvenile idiopathic arthritis.

Area of Science:

  • Pediatric Rheumatology
  • Musculoskeletal Ultrasound
  • Medical Imaging

Background:

  • Clinical decision-making in pediatric arthritis lacks objective bedside imaging tools.
  • Standardized ultrasound (US) protocols are needed for evaluating pediatric ankle inflammation.

Approach:

  • Developed a standardized US scanning protocol for pediatric ankle synovitis and tenosynovitis.
  • 19 pediatric rheumatologists established standardized views and scoring systems.
  • Assessed inter-rater reliability using intraclass correlation coefficients (ICC) on still images and a practical exercise.

Key Points:

  • A nine-view protocol for B-mode and Doppler assessment was finalized.
  • Highly reliable scoring systems were achieved for the anterior tibiotalar joint (ICC: 0.93), talonavicular joint (ICC: 0.86), subtalar joint (ICC: 0.91), and tendons (ICC: 0.96).

Conclusions:

  • A comprehensive and reliable pediatric ankle US protocol and scoring system for synovitis and tenosynovitis were successfully developed.
  • This validated scoring system can serve as an outcome measure in clinical and research settings.
Abstract

Keywords:
JIAanklediagnostic imagingmusculoskeletal ultrasound

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