Clinic of Paediatric and Adolescent Rheumatology, St. Josef-Stift Sendenhorst, Northwest German Center for Rheumatology, Sendenhorst, Germany.
Rheumatology (Oxford). 2021 May 14;60(5):2046-2053. doi: 10.1093/rheumatology/keab004.
This article reviews the role of musculoskeletal ultrasound (MSUS) for the diagnosis, monitoring and treat-to-target management of JIA. Technological advancements in MSUS allow more precise evaluation of arthritis, tenosynovitis and enthesitis versus clinical examination alone, which may assist treatment decisions. In adult studies, serum and synovial biomarkers have correlated with MSUS findings. Within paediatric rheumatology, significant developments in the definition of normal and pathology, a necessity for the future integration of MSUS into treat-to-target management, have already been reached or are underway, which in turn could allow tighter control of disease activity and earlier identification of treatment response and failure, bringing the goal of 'precision medicine' closer. Additionally, the utility of MSUS for the evaluation of subclinical disease remains an unexamined area of interest. 'Ultrasound remission' combined with clinical assessment and immunological markers could therefore potentially improve the treat-to-target management of JIA.
这篇文章回顾了肌肉骨骼超声（MSUS）在 JIA 的诊断、监测和达标治疗管理中的作用。MSUS 技术的进步可以更精确地评估关节炎、腱鞘炎和肌腱炎，而不仅仅是临床检查，这可能有助于治疗决策。在成人研究中，血清和滑膜生物标志物与 MSUS 结果相关。在儿科风湿病学中，已经或正在对正常和病理的定义进行重大改进，这是未来将 MSUS 纳入达标治疗管理的必要条件，这反过来又可以更严格地控制疾病活动，更早地识别治疗反应和失败，使“精准医学”的目标更接近。此外，MSUS 用于评估亚临床疾病的效用仍然是一个未被充分研究的兴趣领域。“超声缓解”与临床评估和免疫标志物相结合，因此可能会改善 JIA 的达标治疗管理。
