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DOI: 10.1055/a-1712-1506
Ultraschalluntersuchungen in der Kinderrheumatologie
Ultrasound examination in paediatric rheumatology
Zusammenfassung
Mit zunehmendem Einsatz des Gelenkultraschalls zeigt sich eine stetige Verbesserung der diagnostischen Möglichkeiten bei der Diagnosestellung, Abgrenzung und im Verlaufsmonotoring kindlich rheumatischer Erkrankungen. So können entzündliche Erkrankungen des kindlichen Kniegelenkes hervorragend differenziert und im Verlauf kontrolliert werden. Neben den typischen sonografischen Zeichen einer Gelenkentzündung lassen sich am Kniegelenk auch rheumatische Sehnenansatzentzündungen und Schleimbeutelentzündungen sicher nachweisen. Wichtige Differenzialdiagnosen können bereits sonografisch ausgeschlosssen oder bestätigt werden. Zunehmende Standards helfen bei der praktischen Durchführung, Beurteilung und Quantifizierung des pathologischen Kniegelenkbefundes.
abstract
With the increasing use of joint ultrasound, significant advances have been made in the diagnosis, differentiation and monitoring of pediatric rheumatic diseases. More specifically, inflammatory disease manifestations of the pediatric knee joint can be differentiated in a detailed way and monitored over the course of the disease. In addition to the typical sonographic signs of synovial inflammation, tendon and entheseal inflammation as well as bursitis can also be reliably detected in the knee joint. Important differential diagnoses can be ruled out or confirmed by sonography. Improvements in the standardization of the sonographic exam support the practical implementation, assessment and quantification of pathological findings in the knee joint.
Publication History
Article published online:
25 February 2022
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Literatur
- 1 Vega-Fernandez P, Ting T, Oberle E. et al The MUSICAL pediatric ultrasound examination – a comprehensive, reliable, time efficient assessment of synovitis. Arthritis Care and Research 2021 Jul 30
- 2 Rebollo-Polo M, Koujok K, Weisser C. et al Ultrasound findings on patients with juvenile idiopathic arthritis in clinical remission. Arthritis Care Res (Hoboken) 2011; 63 (07) 1013-1019
- 3 Windschall D, Malattia C. Ultrasound imaging in paediatric rheumatology. Best Pract Res Clin Rheumatol 2020; 34 (06) 101570 DOI: 10.1016/j.berh.2020.101570. Epub 2020 Aug 25. PMID: 32859519
- 4 Gohar F, Windschall D. The new role of musculoskeletal ultrasound in the treat-to-target management of juvenile idiopathic arthritis. Rheumatology (Oxford) 2021; 60 (05) 2046-2053 DOI: 10.1093/rheumatology/keab004. PMID: 33493330
- 5 Windschall D., Roth J. Sonografie in der pädiatrischen Rheumatologie. In: Wagner N., Dannecker G., Kallinich T, eds. Pädiatrische Rheumatologie. Springer Reference Medizin. Berlin, Heidelberg: Springer; 2021. DOI: 10.1007/978-3-662-60411-3_9-1
- 6 Mandl P, Brossard M, Aegerter P. et al Ultrasound evaluation of fluid in knee recesses at varying degrees of flexion. Arthritis Care Res (Hoboken) 2012; 64: 773-779
- 7 Windschall D, Gohar Trauzeddel R. et al Validation of normative sonographic data in JIA patients with knee arthritis – preliminary data from the imaging working groups of the PReS and GKJR. Pediatric Rheumatology 2021; 19 (Suppl. 01) P163
- 8 Gutierrez M, Filippucci E, Grassi W, Rosemffet M. Intratendinous power Doppler changes related to patient position in seronegative spondyloarthritis. J Rheumatol 2010; 37: 1057-1059
- 9 Roth J, Stinson SE, Chan J. et al Differential pattern of Doppler signals at lower-extremity entheses of healthy children. Pediatr Radiol 2019; 49 (10) 1335-1343
- 10 Roth J, Jousse-Joulin S, Magni-Manzoni S. et al Outcome measures in Rheumatology Ultrasound Group. Definitions for the sonographic features of joints in healthy children. Arthritis Care Res 2015; 67: 136-142
- 11 Windschall D, Collado P, Vojinovic J. et al Age-Related Vascularization and Ossification of Joints in Children: An International Pilot Study to Test Multiobserver Ultrasound Reliability. Arthritis Care Res 2020; 72: 498-506 DOI: 10.1002/acr.23335.
- 12 Collado P, Vojinovic J, Nieto JC. et al Toward Standardized Musculoskeletal Ultrasound in Pediatric Rheumatology: Normal Age-Related Ultrasound Findings. Arthritis Care Res (Hoboken) 2016; 68: 348-356
- 13 Interaktives Online-Lehrbuch Ped-mus www.ped-mus.com
- 14 Windschall D, Trauzeddel R, Haller M. et al Imaging Working Group of the German Society of Rheumatology in Childhood and Adolescense (GKJR). Pediatric musculoskeletal ultrasound: age- and sex-related normal B-mode findings of the knee. Rheumatol Int 2016; 36 (11) 1569-1577
- 15 Spannow AH, Pfeiffer-Jensen M, Andersen NT. et al Ultrasonographic measurements of joint cartilage thickness in healthy children: age- and sex-related standard reference values. J Rheumatol 2010; 37: 2595-2601
- 16 Roth J, Ravagnani V, Backhaus M. et al OMERACT Ultrasound Group. Preliminary Definitions for the Sonographic Features of Synovitis in Children. Arthritis Care Res 2017; 69: 1217-1223
- 17 Jousse-Joulin S, Breton S, Cangemi C. et al Ultrasonography for detecting enthesitis in juvenile idiopathic arthritis. Arthritis Care Res (Hoboken) 2011; 63: 849-855
- 18 Chauvin NA, Ho-Fung V, Jaramillo D. et al Ultrasound of the joints and entheses in healthy children. Pediatr Radiol. 2015; 45: 1344-1354
- 19 Ting TV, Vega-Fernandez P, Oberle EJ. et al CARRA JIA Ultrasound Workgroup. Ultrasound Image Acquisition Protocol and Scoring System for the Pediatric Knee. Arthritis Care Res 2019; 71 (07) 977-985