Ultrasound-detected tenosynovitis in ankles with clinical arthritis and short-term outcome of patients with new-onset juvenile idiopathic arthritis.

IF 3.4 4区 医学 Q2 RHEUMATOLOGY
Stefano Lanni, Orazio De Lucia, Dario Consonni, Federica Chironi, Stefania Costi, Silvia Maria Orsi, Gisella Beretta, Martina Rossano, Roberto Caporali, Carlo Agostoni, Giovanni Filocamo
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Abstract

Objectives: To determine features and frequency of ultrasound (US)-detected tenosynovitis in ankles with clinically active disease and to investigate whether its detection may affect the achievement of inactive disease in patients with new-onset juvenile idiopathic arthritis (JIA).

Methods: The study included children with new-onset JIA and clinically active disease of the ankle. Based on US, patients were stratified as having isolated arthritis or as having tenosynovitis irrespective of the presence of concomitant arthritis in the ankle. Estimation of patients who were able to achieve clinically inactive disease 6 months after starting treatment was assessed by the Kaplan-Meier method. Cox model was used to calculate hazard ratio (HR) and 95% confidence interval (CI). Reliability of US was tested using kappa statistic.

Results: Forty-five patients were recruited. On US, tenosynovitis of the ankle was detected in 28 patients (62.2%); isolated arthritis was found in 17 patients (37.8%). The medial and lateral tendon compartments were the tendon sites most frequently inflamed. Patients with tenosynovitis had similar likelihood of those without tenosynovitis to achieve clinically inactive disease (60.7% and 58.8%, respectively; HR 1.12, 95%CI:0.51-2.45). In the subanalysis excluding patients who were given biologics, the probability of experiencing inactive disease was slightly higher for patients with tenosynovitis compared to those without (64.7% and 54.5%, respectively; HR 1.56, 95%CI: 0.58-4.24). The rate of US reliability was high.

Conclusions: US-detected tenosynovitis is frequent in ankles with clinical arthritis at JIA onset but does not impair the chance of achieving clinically inactive disease in the early disease phase.

临床关节炎患者踝关节超声检测到的腱鞘炎和新发幼年特发性关节炎患者的短期疗效。
目的确定临床活动性疾病踝关节超声(US)检测到的腱鞘炎的特征和频率,并研究其检测是否会影响新发幼年特发性关节炎(JIA)患者非活动性疾病的治疗效果:研究对象包括新发幼年特发性关节炎且踝关节有临床活动性疾病的儿童。根据美国标准,将患者分为孤立性关节炎和腱鞘炎两类,无论踝关节是否伴有关节炎。采用 Kaplan-Meier 法评估患者在开始治疗 6 个月后达到临床非活动期的情况。Cox模型用于计算危险比(HR)和95%置信区间(CI)。使用卡帕统计检验了US的可靠性:结果:共招募了 45 名患者。通过超声波检查发现,28 名患者(62.2%)患有踝关节腱鞘炎;17 名患者(37.8%)患有孤立性关节炎。内侧和外侧肌腱区是最常发炎的肌腱部位。有腱鞘炎的患者与无腱鞘炎的患者获得临床非活动性疾病的可能性相似(分别为 60.7% 和 58.8%;HR 1.12,95%CI:0.51-2.45)。在排除使用生物制剂患者的子分析中,腱鞘炎患者出现非活动性疾病的概率略高于非腱鞘炎患者(分别为 64.7% 和 54.5%;HR 1.56,95%CI:0.58-4.24)。US 的可靠率很高:结论:US检测出的腱鞘炎在JIA发病时有临床关节炎的脚踝中很常见,但不会影响疾病早期达到临床非活动期的机会。
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来源期刊
CiteScore
6.10
自引率
18.90%
发文量
377
审稿时长
3-6 weeks
期刊介绍: Clinical and Experimental Rheumatology is a bi-monthly international peer-reviewed journal which has been covering all clinical, experimental and translational aspects of musculoskeletal, arthritic and connective tissue diseases since 1983.
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