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.
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