Musculoskeletal ultrasound is increasingly being used to diagnose, monitor and treat children with such joint diseases as juvenile idiopathic arthritis. But until now, rheumatologists have not had access to a comprehensive standard of care on how to accurately evaluate pathology in kids’ joints with the imaging technique.
As part of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) ultrasound group, the University of Chicago Medicine’s Deirdre De Ranieri, MD, and five other pediatric rheumatologists in the United States and Canada have developed a novel B-mode and Doppler scoring system for assessing arthritis in the pediatric knee.
Now that we’ve got the hiccups out of the process, it will be easier to set up future scoring systems for the rest of the pediatric joints.
~ Deirdre De Ranieri, MD
The group identified and evaluated 21 views/images of the knee to assess the presence of arthritis in children. They then chose three views for each B-mode and Doppler in a consensus process. Preliminary results indicated overall good reliability but also illustrated the challenges in certain views, especially with Doppler scoring.
With further refinement and validation, however, the scoring system will serve as a clinical tool and to measure outcomes for research, according to De Ranieri. “Now that we’ve got the hiccups out of the process, it will be easier to set up future scoring systems for the rest of the pediatric joints,” she says.
De Ranieri has had extensive training and is the only pediatric rheumatologist in the region certified in the use of musculoskeletal ultrasound by the American College of Rheumatology.