Is ultrasound a validated imaging tool for the diagnosis and management of synovitis in juvenile idiopathic arthritis? A systematic literature review
Is ultrasound a validated imaging tool for the diagnosis and management of synovitis in juvenile idiopathic arthritis? A systematic literature review
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DOI：
10.1002/acr.21644
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发表时间：
2012-07-01
影响因子：
4.7
通讯作者：
D'agostino, Maria Antonietta
中科院分区：
文献类型：
--
作者：
Collado, Paz;Jousse-Joulin, Sandrine;D'agostino, Maria Antonietta
客观超声（US）已被证明是评估类风湿性关节炎滑膜炎的敏感工具。然而，US 在幼年特发性关节炎 (JIA) 中的有效性尚未确定。本研究的目的是评估超声检测滑膜炎以用于 JIA 诊断和随访的有效性。方法 2011 年 2 月 25 日之前在 Embase 和 PubMed 中进行系统文献检索。选择标准包括以英语发表的关于儿童、JIA、US、多普勒、滑膜炎和管理的原创文章。数据是从符合纳入标准的文章中提取的，特别是那些关注美国滑膜炎定义、使用的评分系统和研究的度量属性的文章。对测试的关节类型和数量、研究设计和研究质量进行了评估。结果 确定了 20 项使用 US 评估 JIA 滑膜炎的研究。膝盖是这些文章中最常研究的关节。美国对滑膜炎的定义和量化存在异质性。滑膜炎通常使用灰阶进行评估，只有少数研究采用多普勒技术。 80% 的文章报告了结构效度，其中包括作为主要比较的临床检查。与临床检查相比，超声在检测滑膜炎方面表现出更高的敏感性。很少有研究报告美国 JIA 的可靠性和反应能力。结论 超声是检测幼年特发性关节炎滑膜炎的重要工具，与临床检查相比，超声评估滑膜炎的敏感性更高。然而，还需要进一步的研究来评估滑膜炎随时间变化的可靠性和反应性。
Objective Ultrasound (US) has been shown to be a sensitive tool for evaluating synovitis in rheumatoid arthritis. However, the validity of US has not yet been established in juvenile idiopathic arthritis (JIA). The purpose of this study was to assess the validity of US for detecting synovitis for both diagnosis and followup in JIA. Methods A systematic literature search in Embase and PubMed was performed before February 25, 2011. Selection criteria included original articles on children, JIA, US, Doppler, synovitis, and management published in the English language. Data were extracted from the articles meeting the inclusion criteria, particularly those focused on the US definition of synovitis, scoring systems used, and metric properties studied. The type and number of joints tested, study design, and quality of the studies were assessed. Results Twenty studies were identified using US to assess synovitis in JIA. The knee was the joint most commonly studied in these articles. There was heterogeneity regarding the US definition and quantification of synovitis. Synovitis was commonly assessed by using gray scale and only a few studies included the Doppler technique. Construct validity was reported in 80% of articles, including the clinical examination as the main comparator. US demonstrated higher sensitivity in detecting synovitis as compared to clinical examination. Few studies reported US reliability and responsiveness in JIA. Conclusion US is a valuable tool for detecting synovitis in JIA, and demonstrated higher sensitivity in assessing synovitis as compared to clinical examination. However, further studies are needed for evaluating the reliability and responsiveness to assess synovitis changes over time.