Decreased Cartilage Thickness in Juvenile Idiopathic Arthritis Assessed by Ultrasonography

2013 ◽  
Vol 40 (9) ◽  
pp. 1596-1603 ◽  
Author(s):  
Dan Østergaard Pradsgaard ◽  
Anne Helene Spannow ◽  
Carsten Heuck ◽  
Troels Herlin
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Structural Damage ◽  
Disease Duration ◽  
Cartilage Thickness ◽  
Joint Activity ◽  
Joint Cartilage ◽  
Systemic Jia ◽  
Pip Joint ◽  
Healthy Cohort ◽  
Age And Sex

Objective.Juvenile idiopathic arthritis (JIA) may result in disability, which is caused primarily by degeneration of the osteocartilaginous structures, due to the synovial inflammatory process. It is essential to closely monitor structural damage during the disease course. We aimed to compare ultrasound (US) measurements of joint cartilage thickness in 5 joints in children with JIA to our findings in an age- and sex-related healthy cohort regarding disease duration, joint activity, JIA subtype, age, and sex.Methods.We clinically examined joint activity in 95 patients with JIA and collected parent and physician global assessments. Joint cartilage thickness was assessed by greyscale US in knee, ankle, wrist, metacarpophalangeal, and proximal interphalangeal (PIP) joints. Measurements were compared to reference values of a healthy cohort from a previous study. Medical records were reviewed for JIA subtype, treatment, and disease duration.Results.Joint cartilage thickness was decreased in the knee, wrist, and second PIP joint in children with JIA compared with the healthy cohort (p < 0.001 for all). Patients with oligoarticular JIA had thicker cartilage than patients with polyarticular and systemic JIA. We also found decreased joint cartilage thickness in joints not previously affected by arthritis in children with JIA compared to the same joint in the healthy cohort. We found decreasing cartilage thickness with age and thicker cartilage in boys than in girls.Conclusion.Children with JIA have reduced cartilage thickness compared with children who do not have JIA, and children with polyarticular and systemic JIA have thinner cartilage than children with oligoarticular JIA.

scholarly journals Low Serum IGF-1 in Boys with Recent Onset of Juvenile Idiopathic Arthritis

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Anna-Carin Lundell ◽  
Malin Erlandsson ◽  
Maria Bokarewa ◽  
Hille Liivamägi ◽  
Karin Uibo ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Disease Duration ◽  
Population Based ◽  
Study Group ◽  
Newly Diagnosed ◽  
Biological Mechanisms ◽  
Blood Samples ◽  
Recent Onset ◽  
Estonian Population ◽  
Age And Sex

Background. Liver-derived insulin-like growth factor-1 (IGF-1) contributes bone formation. Decreased IGF-1 levels are common in juvenile idiopathic arthritis (JIA), but whether IGF-1 is related to sex and differ during the pathogenic progress of JIA is unknown. Objective. The aim of this study was to examine IGF-1 levels in boys and girls with newly diagnosed JIA, with established JIA and in controls. Methods. The study group included 131 patients from the Estonian population-based prevalence JIA study. Blood samples were obtained from 27 boys and 38 girls with early JIA (≤1 month from the diagnosis), 29 boys and 36 girls with established JIA (mean disease duration 18 months), and from 47 age- and sex-matched controls. Results. IGF-1 levels in boys were significantly decreased in early JIA compared to male controls, while IGF-1 levels in girls were comparable between JIA and controls. In early JIA, IGF-1 levels were 12-fold lower in boys relative to girls. In controls, IGF-1 levels correlated with both age and height, while these correlations were lost in boys with early JIA. Conclusion. We report a sex-dependent deficiency in serum IGF-1 in boys with early JIA, which argues for sex-related differences in biological mechanisms involved in the disease pathogenesis.

Ultrasound detected changes in joint cartilage thickness in juvenile idiopathic arthritis

2019 ◽  
Vol 22 (7) ◽  
pp. 1263-1270 ◽  
Author(s):  
Sonali Mitra ◽  
Partha Pratim Samui ◽  
Moumita Samanta ◽  
Rakesh Kumar Mondal ◽  
Avijit Hazra ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Cartilage Thickness ◽  
Joint Cartilage

scholarly journals Joint cartilage thickness and automated determination of bone age and bone health in juvenile idiopathic arthritis

2017 ◽  
Vol 15 (1) ◽  
Author(s):  
Marinka Twilt ◽  
Dan Pradsgaard ◽  
Anne Helene Spannow ◽  
Arne Horlyck ◽  
Carsten Heuck ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Bone Health ◽  
Bone Age ◽  
Cartilage Thickness ◽  
Joint Cartilage ◽  
Automated Determination

Ultrasonographic Measurements of Joint Cartilage Thickness in Healthy Children: Age- and Sex-Related Standard Reference Values

2010 ◽  
Vol 37 (12) ◽  
pp. 2595-2601 ◽  
Author(s):  
ANNE HELENE SPANNOW ◽  
MOGENS PFEIFFER-JENSEN ◽  
NIELS T. ANDERSEN ◽  
TROELS HERLIN ◽  
ELISABETH STENBØG
Keyword(s):  
Reference Values ◽  
Bone Erosion ◽  
Standard Procedure ◽  
Age Groups ◽  
Conventional Radiography ◽  
Cartilage Thickness ◽  
Healthy Children ◽  
Joint Cartilage ◽  
Cross Sectional ◽  
Age And Sex

Objective.Loss of joint cartilage may be an early feature of chronic inflammatory joint diseases like juvenile idiopathic arthritis (JIA). Conventional radiography usually detects only late changes such as joint space narrowing and bone erosion rather than early inflammatory changes. Joint cartilage is easily visualized with high-frequency ultrasonography (US), but age- and gender-related normal standard reference values should be established before US measurement of cartilage thickness becomes standard procedure in the clinic.Methods.A cross-sectional study of bilateral grey-scale US cartilage thickness of the knee, ankle, wrist, and second metacarpophalangeal (MCP) and second proximal interphalangeal (PIP) joints was performed in 394 (215 boys/179 girls) healthy Danish Caucasian children aged between 7 and 16 years.Results.Cartilage thickness differed significantly between sexes (p < 0.001 for all joints), boys having thicker cartilage than girls. Cartilage thickness clearly decreased with increasing age in both sexes. A formula for calculating sex-specific cartilage thickness at different ages in childhood is suggested. No difference between the right and left side of the investigated joints was observed.Conclusion.Using US, we established age- and sex-related normal reference intervals for cartilage thickness of the knee, ankle, wrist, and MCP and PIP joints in 7- to 16-year-old children, and designed a formula for calculating hyaline cartilage thickness in all age groups throughout childhood.

scholarly journals Joint cartilage thickness measured by ultrasound in juvenile idiopathic arthritis

2012 ◽  
Vol 10 (S1) ◽  
Author(s):  
D Pradsgaard ◽  
AH Spannow ◽  
CW Heuck ◽  
A Hørlyck ◽  
T Herlin
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Cartilage Thickness ◽  
Joint Cartilage

P030 Impact of methotrexate on growth in children with Juvenile Idiopathic Arthritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
A Fazaa ◽  
F Rouatbi ◽  
S Miladi ◽  
K Ouenniche ◽  
L Souabni ◽  
...  
Keyword(s):  
Growth Rate ◽  
Juvenile Idiopathic Arthritis ◽  
Growth Velocity ◽  
Disease Duration ◽  
Growth Parameters ◽  
Standard Deviation Score ◽  
Disease Onset ◽  
Lower Growth ◽  
Systemic Jia

Abstract Background Juvenile idiopathic arthritis (JIA) is a heterogeneous group of chronic inflammatory disease which could be responsible for functional impairment and severe growth disturbance. Conventional disease-modifying antirheumatic drugs, such as methotrexate (MTX), may improve growth velocity especially by regulating systemic inflammation. The objective of this study was to evaluate the effect of MTX on growth parameters in pre-pubertal children with JIA and to determine the factors affecting the growth velocity. Methods We assessed height and changes in the height standard deviation score (SDS) at disease onset, at the onset of MTX and at the last follow-up visit in a cross-sectional study of JIA children. All patients were pre-pubertal when MTX began and were followed for at least 6 months afterward. We compared growth parameters (height, growth rate, weight and body mass index (BMI)) in responders and non-responders to MTX. The growth rate was defined as the number of millimeters of height acquired during 1 year. Associations between changes in the height SDS and discrete variables were evaluated using χ2 or Fisher’s exact tests. The significance level was set at 0.05. Results We enrolled 36 pre-pubertal children with JIA (34 boys and 12 girls) who had been treated with MTX orally. Median patient age was 6.2 years [4–13] at the onset of MTX and 8.4 years [6.1–14.9] at the latest follow-up. The median disease duration was 2.7 years [2.5–5.3]. Twenty-one patients (58.3%) had oligoarticular JIA, 2 patients (5.5%) had systemic JIA, 10 (27.7%) had polyarticular JIA and 3 (8.3%) had enthesitis-related arthritis. Nineteen children (52.7%) had received corticosteroids during an average period of 1.7 years [0.6–3] with a mean of 10 mg/day of prednisone or equivalent. The median duration of MTX at the latest follow-up was 3.1 years [0.62–5.5] with a mean MTX dose of 10 mg/m2/week [10–15]. Twenty-eight patients responded to MTX treatment and 8 did not. There were no significant differences between the responders and non-responders for age at treatment initiation, disease duration and mean MTX dose. At MTX onset, no significant differences between the two groups in terms of height (P = 0.52), growth rate (P = 0.08), weight (P = 0.74) and BMI (P = 0.9) were found. One year after MTX therapy, mean height (0.2 vs -1.1; P = 0.03), mean growth rate (0.5 vs –2.9 SDS; P = 0.01), mean weight (0.4 vs -2.3 SDS; P = 0.01) and mean BMI (0.6 vs -1.9; P = 0.04) were significantly higher in the responder group than in non responders, respectively. At the latest follow-up, this increase was significantly maintained for growth rate (P = 0.001) and height (P = 0.002) in the responder group. In the multivariate analysis, patients who required &gt;10 mg/m2/week of MTX, systemic JIA and patients with reliance on steroids had a significantly lower growth velocity after the onset of MTX (P &lt; 001, P = 0.02, P = 0.02 respectively). Conclusion In our study, the increase in growth parameters in pre-pubertal children with JIA was associated with a better control of the disease activity under MTX therapy.

scholarly journals AB1123 PROGRESSION OF FINGER JOINT CARTILAGE DAMAGE EVALUATED BY ULTRASOUND IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1850.2-1851
Author(s):  
T. Ogura ◽  
A. Hirata ◽  
S. Takenaka ◽  
Y. Inoue ◽  
T. Kagtagiri ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Duration ◽  
Cartilage Damage ◽  
Joint Space ◽  
Cartilage Thickness ◽  
Finger Joint ◽  
Joint Cartilage ◽  
Direct Evaluation ◽  
The Us

Background:Cartilage damage in rheumatoid arthritis (RA) has been evaluated by joint space narrowing (JSN) in X-ray, despite the fact that it is not a direct evaluation of cartilage. We have recently reported that direct evaluation of finger joint cartilage thickness evaluated by ultrasound (US) is valid and useful for patients with RA1).Objectives:In this study, we aimed to examine the progression of cartilage damage in RA patients.Methods:Forty-six patients with RA who had completed the US evaluation of finger joint cartilage thickness at baseline and after 1 year were included in this study. The cartilage thickness of metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of 2nd to 5th fingers were bilaterally visualized and measured at the middle portion of MCP and PIP joints from a longitudinal dorsal view, with approximately 90 degrees flexion. Cartilage thickness was measured from the base of the cartilage to the interface artefact at the cartilage surface by calculating the pixel counts on DICOM images.Results:In patients, 78% were female, the median age was 68 years and the median disease duration of the patients was 6 years. The median DAS28-CRP at baseline was 2.6. The sum of total cartilage thickness from 16 joints per patient ranged from 3.1 to 9.1 mm (median 6.4 mm) at baseline, and it was significantly correlated with disease duration (ρ=-0.423, p=0.003). A significant decrease from the baseline in the cartilage thickness (median -1.6%) was observed after 1 year (p=0.041). Furthermore, patients with persistently moderate/high disease activity for 1 year by DAS28-CRP (n=9) showed a greater decrease in the cartilage thickness than the remaining patients with controlled disease activity (n=37) (median -5.9% versus -1.5%, respectively, p=0.029).Conclusion:This study further supported the validity and usefulness of joint cartilage thickness evaluation by US in patients with RA.References:[1]Ogura T, et al. Arthritis Care Res 2019 Oct 25.Disclosure of Interests:Takehisa Ogura: None declared, Ayako Hirata: None declared, Sayaka Takenaka: None declared, Yuki Inoue: None declared, Takaharu Kagtagiri: None declared, Yuto Takakura: None declared, Hideki Ito: None declared, Hideto Kameda Grant/research support from: Abbvie, Asahi-Kasei, Chugai, Eisai, Mitsubishi-Tanabe and Novartis, Consultant of: Abbvie, Boehringer, Celgene, Eli Lilly, Janssen, Novartis, Sanofi, UCB, Speakers bureau: Abbvie, Asahi-Kasei, BMS, Chugai, Eisai, Eli Lilly, Janssen, Mitsubishi-Tanabe, Novartis and Pfizer

scholarly journals Assessment of the relationship between estimated cardiovascular risk and structural damage in patients with axial spondyloarthritis

2020 ◽  
Vol 12 ◽  
pp. 1759720X2098283
Author(s):  
María Lourdes Ladehesa-Pineda ◽  
Iván Arias de la Rosa ◽  
Clementina López Medina ◽  
María del Carmen Castro-Villegas ◽  
María del Carmen Ábalos-Aguilera ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cluster Analysis ◽  
Structural Damage ◽  
Disease Duration ◽  
Linear Models ◽  
Axial Spondyloarthritis ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Atherosclerotic Plaques ◽  
Cross Sectional

Aims: To evaluate the association of estimated cardiovascular (CV) risk and subclinical atherosclerosis with radiographic structural damage in patients with axial spondyloarthritis (axSpA). Methods: Cross-sectional study including 114 patients axSpA from the SpA registry of Córdoba (CASTRO) and 132 age- and sex-matched healthy controls (HCs). Disease activity and the presence of traditional CV risk factors were recorded. The presence of atherosclerotic plaques and carotid intima media thickness (cIMT) were evaluated through carotid ultrasound and the SCORE index was calculated. Radiographic damage was measured though modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). The association between mSASSS and SCORE was tested using generalized linear models (GLM), and an age-adjusted cluster analysis was performed to identify different phenotypes dependent on the subclinical CV risk. Results: Increased traditional CV risk factors, SCORE, and the presence of carotid plaques were found in axSpA patients compared with HCs. The presence of atherosclerotic plaques and SCORE were associated with radiographic structural damage. The GLM showed that the total mSASSS was associated independently with the SCORE [β coefficient 0.24; 95% confidence interval (CI) 0.10–0.38] adjusted for disease duration, age, tobacco, C-reactive protein, and non-steroidal anti-inflammatory drugs (NSAID) intake. Hard cluster analysis identified two phenotypes of patients. Patients from cluster 1, characterized by the presence of plaques and increased cIMT, had a higher prevalence of CV risk factors and SCORE, and more structural damage than cluster two patients. Conclusion: Radiographic structural damage is associated closely with increased estimated CV risk: higher SCORE levels in axSpA patients were found to be associated independently with mSASSS after adjusting for age, disease duration, CRP, tobacco and NSAID intake.

scholarly journals Age and Sex Specific Trends in Incidence of Juvenile Idiopathic Arthritis in Danish Birth Cohorts from 1992 to 2002: A Nationwide Register Linkage Study

2021 ◽  
Vol 18 (16) ◽  
pp. 8331
Author(s):  
Isabel Cardoso ◽  
Peder Frederiksen ◽  
Ina Olmer Specht ◽  
Mina Nicole Händel ◽  
Fanney Thorsteinsdottir ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Regression Model ◽  
Incidence Rate ◽  
Poisson Regression ◽  
Linkage Study ◽  
Incidence Rates ◽  
Age Group ◽  
Poisson Regression Model ◽  
Birth Cohorts ◽  
Age And Sex

This study reports age- and sex-specific incidence rates of juvenile idiopathic arthritis (JIA) in complete Danish birth cohorts from 1992 through 2002. Data were obtained from the Danish registries. All persons born in Denmark, from 1992–2002, were followed from birth and until either the date of first diagnosis recording, death, emigration, 16th birthday or administrative censoring (17 May 2017), whichever came first. The number of incident JIA cases and its incidence rate (per 100,000 person-years) were calculated within sex and age group for each of the birth cohorts. A multiplicative Poisson regression model was used to analyze the variation in the incidence rates by age and year of birth for boys and girls separately. The overall incidence of JIA was 24.1 (23.6–24.5) per 100,000 person-years. The rate per 100,000 person-years was higher among girls (29.9 (29.2–30.7)) than among boys (18.5 (18.0–19.1)). There were no evident peaks for any age group at diagnosis for boys but for girls two small peaks appeared at ages 0–5 years and 12–15 years. This study showed that the incidence rates of JIA in Denmark were higher for girls than for boys and remained stable over the observed period for both sexes.

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