Clinical, Laboratory, and Ultrasound Characteristics of Knee Involvement in Children With Juvenile Rheumatoid Arthritis

Hisham M. Habib, Ghada O. Elsedfy, Dalia A Shaheen, Ashraf A. Eissa


Background: The aim of this study was to evaluate clinical, laboratory, and ultrasound characteristics of the knee involvement a cohort of juvenile rheumatoid arthritis patients.

Methods: Nineteen JRA children with mean age of 10.2 years were recruited. Clinical assessment of the knee score was performed. Patients with a mean total score >=1 were classified as having active knee involvement. The following measurements were recorded: Ritchie articular index score, Steinbrocker grading system, and the Childhood Health Assessment Questionnaire. Visual analog scale. Laboratory investigations were performed, including complete blood count, erythrocyte sedimentation rate, C-reactive protein, and rheumatoid factor, antinuclear antibodies. Knee ultrsonography was done for both knees of all patients on the same day as the clinical and laboratory investigation.

Results: Active knee group comprised 12 patients with 17 active knees. Mean Ritchie articular index score, was found to be 15.2 9.6, mean of Steinbrocker grading system was 2 1.2, while mean of Childhood Health Assessment Questionnaire was 1.2 1.1, and that of Visual analog scale was 3.8 2.4. Laboratory characteristics of patients with knee involvement showed a statistically A significant increase in ESR [54.5 18.9 vs. 24.3 14.8, p = 0.001] CRP levels [22.7 11.4 vs. 12.6 4p = 0.011], and decrease in hemoglobin concentration [9.4 2.7 vs. 12.6 2.4, p = 0.02]. Ultrasonography characteristics showed a statistically significant increase in knee synovial thickness and knee effusion volume.

Conclusion: knee joint is considered a mirror image for the activity status of patients with JRA, with a clinical, laboratory and ultrasonic activity data consistent with the pathological profile inside the knee.



Juvenile rheumatoid arthritis; Knee joint; Clinical; Laboratory; Ultrsonography

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