الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 32 |  |  |
| | | from | 32 | | |
Abstract
Juvenile idiopathic arthritis is a heterogenous group of chronic arthritides affecting children under the age of 16 years. Despite the heterogeneity, all forms of JIA can result in significant erosive joint disease affecting function and quality of life (Kimme et al., 2010).
It is important to find ways to diagnose patients early in the disease course in order to use active treatment modalities before damage has occurred and to give them the necessary support to diminish the risk for negative influence on physical and psychosocial development during childhood and adolescence (Huygen et al., 2000).
Also identifying predictors of poor outcome in JIA children may help to target therapies to those most likely to have poor outcomes and avoid over treatment in those most likely to have good outcome (Kimme et al., 2010).
The aim of this study was to determine whether early clinical, laboratory and musculoskeletal ultrasound characteristics can be used as early detectors and outcome predictors of JIA.
This study comprised 40 patients with JIA diagnosed according to the ILAR criteria (Petty et al., 1998), and 20 healthy control children. All patients were subjected to the following assessment at base line and at follow up after 6 months:
Clinical evaluation.
Radiological evaluation.
MSUS examination.
Laboratory evaluation.
Disease activity and outcome measures (JADAS-27, CHAQ-DI, JAQQ score, Phys GA, Par GE and pain assessment by VAS.
The controls were subjected to:
MSUS examination.
Laboratory evaluation.
Of the 40 patients, 6 patients (15%) had systemic onset subtype, 8 (20%) oligoarticular extended, 9 (22.5%) oligoarticular persistent, 5 (12.5%) polyarticular RF +ve, 6 (15%) polyarticular RF –ve, 5 (12.5%) enthesitis related subtype and only one patient (2.5%) had psoriatic JIA. Five patients (12.5%) were RF +ve and 35 (87.5%) were RF –ve, 14 patients (35%) were ANA +ve and 26 (65%) were –ve, 5 patients (12.5%) were anti CCP +ve and 35 (87.5%) were –ve, ESR was elevated in 37 patients (92,5%), CRP was positive in 32 patients (80%), anemia was present in 6 patients (15%), while thrombocytosis was present in 5 patients (12.5%).
In our study, US detected more synovitis than clinical examination (subclinical synovitis) both at base line and at follow up.
Musculoskeletal ultrasonography led to classify 4 patients (had only arthralgia on clinical examination) as oligoarticular subtype, and also MSUS led to classify 2 patients (had no clinical synovitis) as polyarticular RF +ve, and another 2 patients as polyarticular RF -ve JIA.