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Rheumatology Advance Access originally published online on April 4, 2006
Rheumatology 2006 45(10):1273-1275; doi:10.1093/rheumatology/kel028
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Quantitative ultrasonometry of the calcaneus in children with juvenile idiopathic arthritis

S. Kutilek, M. Bayer, P. Dolezalova and D. Nemcova

Department of Pediatrics, 1st Medical Faculty, Charles University, Prague, Czech Republic.

Correspondence to: S. Kutilek, Center for Clinical and Basic Research (CCBR), Kyjevská 40, 530 03 Pardubice, Czech Republic. E-mail: sk{at}ccbr.cz


  Abstract

Objectives. To evaluate bone quality by means of quantitative ultrasonometry (QUS) in children with juvenile idiopathic arthritis (JIA).

Methods. Seventy children [37 with oligoarticular JIA, mean age (±S.D.) 10.54 ± 3.42 yr; and 33 with polyarticular rheumatoid factor negative JIA, mean age (± S.D.) 11.33 ± 2.88 yr] were enrolled. Quantitative ultrasonometry was measured on both heels with a Cuba Clinical portable device. Body height, weight and body mass index were recorded together with disease duration and cumulative dose of prednisone.

Results. The lowest QUS parameters were observed in children with polyarticular JIA (P< 0.001 and 0.01 when compared with reference data and oligoarticular JIA, respectively). In children with oligoarticular JIA, the QUS values were also significantly lower in comparison with the reference data (P< 0.002). The QUS parameters were strongly influenced by body height, and to a lesser degree by body weight. In children with polyarticular JIA, there were significant inverse correlations between QUS parameters and disease duration [r=–0.57, P< 0.01 for broadband ultrasound attenuation (BUA) and r = – 0.67, P< 0.01 for velocity of sound (VOS)]. Similarly, there were inverse correlations between QUS and cumulative dose of prednisone (r = – 0.48, P< 0.05 for BUA and r =– 0.50, P < 0.01 for VOS, respectively). Similar results were obtained when BUA and VOS were adjusted for height.

Conclusions. Disease duration and cumulative dose of prednisone in children with polyarticular JIA are risk factors of stunted growth and decreased QUS values of bone quality.

KEY WORDS: Quantitive ultrasound, Juvenile idiopathic arthritis, Bone quality

Submitted 19 August 2005; revised version accepted 6 January 2006.
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