R03 Establishing normal values in ultrasound images of healthy children’s joints to facilitate differentiation from inflammatory changes seen in juvenile idiopathic arthritis

Abstract

Background: Studies in children looking at the additional value of musculoskeletal ultrasound (MSUS) in detecting flare of arthritis fail to consistently show a beneficial effect in predicting disease flares. One hypothesis that explains the negative finding in these studies is that positive Power Doppler (PD)-an ultrasound sign that predicts active disease in adults-may be present in healthy children as part of normal joint development. This study aims to describe power Doppler and greyscale appearances in ultrasound scans of the wrist, tibio-talar joint, and proximal interphalangeal joint (PIPJ) of the middle finger in healthy children aged 2-16 years in a school and nursery setting. Method(s): In a cross-sectional cohort study 300 healthy children aged 2-16 years will be recruited at various schools and nurseries. After informed consent is taken, a questionnaire is filled in by parents about inclusion and exclusion criteria and daily activities of the child. Heights and weights of eligible children are recorded and an ultrasound examination of the wrist, the PIPJ 3rd finger and the ankle is done. All pictures taken during MSUS will be measured and reviewed for quality by two independent investigators. Inter-user and intra-user variability will be assessed. Outcome measures per joint will be 1. Presence of positive PD, location of PD signal if present, presence of synovial thickening, presence of synovial fluid, volume of fluid if present, presence of irregular joint surface, millimeters of cartilage on the epiphysis of the wrist or ankle. Result(s): This is ongoing research, results are not yet available. Conclusion(s): This is ongoing research, results and conclusions are not yet available.