{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:16:49Z","timestamp":1785457009420,"version":"3.56.0"},"reference-count":13,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Clinical examination (CE) and musculoskeletal ultrasound (MSUS) of ten joints (knee, ankle, wrist, elbow, II-MCP) and their extra-articular (EA) compartments (tendons and bursae) were performed on 35 consecutive patients with active juvenile idiopathic arthritis (JIA) (active group) to test how the extension of MSUS examinations to EA changes the concordance between MSUS and CE. The overall concordance between CE and MSUS, measured with Cohen\u2019s Kappa (k), was moderate (k = 0.43); the addition of EA MSUS increased the concordance in all joints, with the exclusion of II-MCP (k = 0.49). In the ankle and wrist, the k increase was relevant (k from 0.13 to 0.27 and 0.11 to 0.41). In the active group patients, we observed 44 subclinical synovitis; the number of subclinical synovitis per patient was correlated with JADAS-27 (p = 0.03) and was higher in a control group composed of 15 patients with persistent disease remission (1.3 vs. 0.4 p = 0.03). Our results show that EA compartments should always be evaluated during MSUS. Furthermore, we demonstrate a moderate concordance between CE and MSUS in JIA; the finding of subclinical synovitis is common in patients with active diseases and is related to disease activity.<\/jats:p>","DOI":"10.3390\/children9030333","type":"journal-article","created":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T08:17:03Z","timestamp":1646122623000},"page":"333","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Discordance between Clinical and Ultrasound Examinations in Juvenile Idiopathic Arthritis: An Experimental Approach"],"prefix":"10.3390","volume":"9","author":[{"given":"Francesco","family":"Licciardi","sequence":"first","affiliation":[{"name":"Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics Sciences, Regina Margherita Children\u2019s Hospital, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Petraz","sequence":"additional","affiliation":[{"name":"Citt\u00e0 della Salute e della Scienza, Department of Radiology, Regina Margherita Children\u2019s Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0934-2907","authenticated-orcid":false,"given":"Carlotta","family":"Covizzi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics Sciences, Regina Margherita Children\u2019s Hospital, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Santarelli","sequence":"additional","affiliation":[{"name":"Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics Sciences, Regina Margherita Children\u2019s Hospital, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlotta","family":"Cirone","sequence":"additional","affiliation":[{"name":"Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics Sciences, Regina Margherita Children\u2019s Hospital, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Mulatero","sequence":"additional","affiliation":[{"name":"Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics Sciences, Regina Margherita Children\u2019s Hospital, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Robasto","sequence":"additional","affiliation":[{"name":"Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics Sciences, Regina Margherita Children\u2019s Hospital, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Dellepiane","sequence":"additional","affiliation":[{"name":"Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics Sciences, Regina Margherita Children\u2019s Hospital, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvana","family":"Martino","sequence":"additional","affiliation":[{"name":"Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics Sciences, Regina Margherita Children\u2019s Hospital, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Montin","sequence":"additional","affiliation":[{"name":"Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics Sciences, Regina Margherita Children\u2019s Hospital, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviana","family":"Ravagnani","sequence":"additional","affiliation":[{"name":"SSD Allergologia ed Immunologia Clinica, Ospedale C. Poma, ASST Mantova, 46100 Mantova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1093\/rheumatology\/ket148","article-title":"Reduced joint assessment vs comprehensive assessment for ultrasound detection of synovitis in juvenile idiopathic arthritis","volume":"52","author":"Collado","year":"2013","journal-title":"Rheumatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1002\/art.24823","article-title":"Comparison of clinical versus ultrasound-determined synovitis in juvenile idiopathic arthritis","volume":"61","author":"Epis","year":"2009","journal-title":"Arthritis Rheum."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1093\/rheumatology\/kep339","article-title":"The detection of subclinical synovitis by ultrasound in oligoarticular juvenile idiopathic arthritis: A pilot study","volume":"49","author":"Haslam","year":"2010","journal-title":"Rheumatology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2366","DOI":"10.1002\/art.34373","article-title":"Remission, minimal disease activity, and acceptable symptom state in juvenile idiopathic arthritis: Defining criteria based on the juvenile arthritis disease activity score","volume":"64","author":"Consolaro","year":"2012","journal-title":"Arthritis Rheum."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1002\/acr.23130","article-title":"Preliminary Definitions for the Sonographic Features of Synovitis in Children","volume":"69","author":"Roth","year":"2017","journal-title":"Arthritis Care Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.3899\/jrheum.161240","article-title":"The OMERACT Ultrasound Group: A Report from the OMERACT 2016 Meeting and Perspectives","volume":"44","author":"Terslev","year":"2017","journal-title":"J. Rheumatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1002\/acr.23335","article-title":"Age-related vascularization and ossification of joints in children: An international pilot study to test multi-observer ultrasound reliability","volume":"72","author":"Windschall","year":"2017","journal-title":"Arthritis Care Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1002\/acr.22670","article-title":"Toward Standardized Musculoskeletal Ultrasound in Pediatric Rheumatology: Normal Age-Related Ultrasound Findings","volume":"68","author":"Collado","year":"2016","journal-title":"Arthritis Care Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2409","DOI":"10.3899\/jrheum.091262","article-title":"Prospective Evaluation of Clinical and Ultrasound Findings in Ankle Disease in Juvenile Idiopathic Arthritis: Importance of Ankle Ultrasound","volume":"37","author":"Pascoli","year":"2010","journal-title":"J. Rheumatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1002\/acr.22846","article-title":"Delineating the Application of Ultrasound in Detecting Synovial Abnormalities of the Subtalar Joint in Juvenile Idiopathic Arthritis","volume":"68","author":"Lanni","year":"2016","journal-title":"Arthritis Care Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1002\/acr.24241","article-title":"Comparison Between Clinical and Ultrasound Assessment of the Ankle Region in Children with Juvenile Idiopathic Arthritis","volume":"73","author":"Lanni","year":"2021","journal-title":"Arthritis Care Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1136\/annrheumdis-2017-211696","article-title":"Baseline ultrasound examination as possible predictor of relapse in patients affected by juvenile idiopathic arthritis (JIA)","volume":"77","author":"Ravagnani","year":"2018","journal-title":"Ann. Rheum. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1002\/art.24516","article-title":"Development and validation of a composite disease activity score for juvenile idiopathic arthritis","volume":"61","author":"Consolaro","year":"2009","journal-title":"Arthritis Rheum."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/3\/333\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:30:19Z","timestamp":1760135419000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/3\/333"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,1]]},"references-count":13,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["children9030333"],"URL":"https:\/\/doi.org\/10.3390\/children9030333","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,1]]}}}