Informativeness of X-Ray and Ultrasound Techniques in the Diagnosis of Reactive Arthritis in Children
Background. Reactive arthritis is an important problem in pediatrics, which is associated with its highest specific weight (41–56 %) in the structure of the joint pathology in children. The importance of the problem is also caused by the risk of chronicity of inflammatory process and transformation in juvenile rheumatoid arthritis and osteoarthritis. Timely diagnosis plays a big role in the course and outcomes of the disease. Along with clinical and laboratory examination, X-ray and ultrasonic methods play an important role in the diagnosis and differential diagnosis of joint diseases in children. Objective: to optimize the diagnosis of reactive arthritis in children by means of a comparative evaluation of the informativeness of radiological and ultrasonic techniques. Materials and methods of the study. A total of 30 children with a diagnosis of reactive arthritis aged 2 to 16 years were examined. Along with the generally accepted clinical-laboratory and X-ray examination, all patients underwent ultrasonography of the joints. Results. The changes on radiographs were recorded only in 10 (33.3 ± 8.7 %) children in the form of an increase in the volume and thickening of periarticular tissues, 2 (6.7 ± 4.6 %) children had expansion of joint space of the affected joint. Sensitivity of radiography as a method for the diagnosis of reactive arthritis in children was 40 %. Ultrasound examination of the joints revealed pathological changes in 100 % of cases. During ultrasonography of the joints, we have detected the changes in the joints as synovitis, thickening of synovial membranes, expansion of joint space, tendinitis, bursitis. Conclusion. In the diagnosis of the different course of reactive arthritis, the method of ultrasonic imaging of inflammatory changes in the joints, which has 100% sensitivity, becomes very important. Ultrasonography, as a non-invasive, available method with no contraindications, is a significantly (p < 0.05) more sensitive imaging technique in arthritis in children as compared to the X-ray joint research method.
Berezhnyy VV., Marushko TV., Marushko YuV. Klinichna revmatolohiya dytyachoho viku [Clinical Rheumatology of childhood]. Cherkasy: Vydavets' Chabanenko Yu; 2009.192 p. Ukrainian.
Beketova HV., Soldatova OV., Horyacheva YP. [Differential diagnosis of articular syndrome in pediatrics. Сhapter 1. Arthropathy]. Pediatrics. Eastern Europe. 2013; 4 (04): 108–124. Russian.
Zholobova ES., Heppe NA. Reaktyvny artryt [Reactive arthritis]. Мoscow: GEOTAR-Меdiа; 2011. 720 p. Russian.
Klymenko VA., Savvo VM., Yanovskaya EA. [Features of modern current of reactive arthritis in children]. World of Medicine and Biology. 2014;3(45):65-68. Russian.
Lebets YS., Pan'ko NA. [Features of onset and course of reactive arthritis in children]. Zdorov'e rebenka. 2013;6 (49):37-42. Russian.
Lebets' IC., Pan'ko NA., Zaytseva YeM. [Prohnostychni markery khronizatsiyi patolohichnoho protsesu pry reaktyvnykh artrytakh u ditey]. In: [Problemni pytannya diahnostyky ta likuvannya ditey z somatychnoyu patolohiyeyu]. – Kharkiv; 2014. - P. 127-128. Ukrainian.
Natal'chenko HY. [Etiopathogenesis, clinics, diagnostics of reactive arthritis among children (literature review)]. 2011;2(46):110-112. Russian.
Pyrohova ZY., Ryabchuk FN. [Clinical and laboratory characteristics of persistent Chlamydia and Mycoplasma infections in children]. Lechashchyy vrach. 2011; 1:42-45. Russian.
Saatova HM., Ashyrov K. [Dynamics of clinical and functional, radiological and microcirculatory changes in different types of reactive arthritis in children]. 2014; 14(5):48-152. Russian.
Shevchenko NS. [Reactive arthritis as a risk factor for osteoarthritis in adolescents]. Sovremennaya pedyatryya. 2012;4:70-73. Russian.
Aupiais C. Aetiology of arthritis in hospitalised children: an observational study / C. Aupiais, B. Ilharreborde, [et al.] // Arch Dis Child. 2015 Aug;100(8):742-7. doi: 10.1136/archdischild-2014-307490. Epub 2015 Mar 2.
Filer A. Utility of ultrasound joint counts in the prediction of rheumatoid arthritis in patients with very early synovitis / Ann Rheum Dis. 2011 Mar;70(3):500-7. doi: 10.1136/ard.2010.131573. Epub 2010 Nov 29.
Hazlewood G. Algorithm for identification of undifferentiated peripheral inflammatory arthritis: a multinational collaboration through the 3e initiative / G. Hazlewood, D. Aletaha, L. Carmona et al. // The Journal of Rheumatology. – 2011. - Vol. 87. – P. 84-89. doi 10.3899/jrheum.101076.
Kirkhus E. Differences in MRI findings between subgroups of recent-onset childhood arthritis. / E. Kirkhus, O. Riise, T. Reiseter et al. // Pediatr Radiol. 2011 Apr; 41(4): 432–440. Published online 2010 Dec 7. doi: 10.1007/s00247-010-1897-y.
Kobayashi S. Reactive arthritis induced by tonsillitis: a type of "focal infection" / S. Kobayashi, G. Ichikawa // Adv Otorhinolaryngol. 2011;72:79-82. doi: 10.1159/000324612. Epub 2011 Aug 18.
Metwalli Z. MRI of suspected lower extremity musculoskeletal infection in the pediatric patient: how useful is bilateral imaging? / Z. Metwalli, J.H. Kan, K.A. Munjal et al. // AJR Am J Roentgenol. 2013 Aug;201(2):427-32. doi: 10.2214/AJR.12.9644.
Patil P. Role of diagnostic ultrasound in the assessment of musculoskeletal diseases/ P. Patil, B. Dasgupta // Ther Adv Musculoskelet Dis. 2012 Oct; 4(5): 341–355. doi: 10.1177/1759720X12442112.
Recent-onset childhood arthritis - Association with Streptococcus pyogenes in a population-based study / Riise O.R., Lee A., Cvancarova M. [et al.] // Rheumatology (Oxford). 2008 Jul;47(7):1006-11. doi: 10.1093/rheumatology/ken122. Epub 2008 Apr 17.
Sarker H.N. Post-streptococcal reactive arthritis: a review / H.N. Sarker, B.P. Das // The ORION Medical Journal 2009 Sep;32(3):690-691.
Tok F. Musculoskeletal ultrasound in pediatric rheumatology. / F. Tok, E. Demirkaya, L. Ozcakar. // Pediatr Rheumatol Online J. 2011; 9: 25. Published online 2011 Sep 12. doi: 10.1186/1546-0096-9-25.
- There are currently no refbacks.
Copyright (c) 2016 CHILD`S HEALTH
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2017