{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:44:40Z","timestamp":1780472680317,"version":"3.54.1"},"reference-count":44,"publisher":"The Journal of Rheumatology","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2010,11]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>To prospectively compare clinical examination of the ankle structures with ultrasound (US) findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>In 42 children with juvenile idiopathic arthritis (JIA; 25 girls, 17 boys, mean age 11.3 yrs, range 2.3\u201322.3 yrs), a total of 61 swollen\/painful ankles were assessed clinically and ultrasonographically. Accurate clinical examination of the entire ankle joint was performed, focusing especially on 3 regions \u2014 tibiotalar joint and medial and lateral tendons. Clinical and US findings were both scored 0\u20133 (normal-severe).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>US demonstrated no signs of tibiotalar joint effusion in 14 out of 43 ankles considered clinically involved. For the medial tendons, US showed tenosynovitis in 13 ankles out of 31 thought to be clinically normal; and for the lateral tendons, of the 19 deemed to be clinically involved, less than 50% had involvement on US. Very poor agreement was observed comparing the clinical and US scores for the 3 regions: tibiotalar joint, kappa = 0.3; medial tendons, kappa = 0.24; lateral tendons, kappa = 0.25. With regard to other ankle structures, only 39% of the subtalar (talocalcaneal) joints considered clinically involved were deemed abnormal on US. Finally, of the 10 ankles with talonavicular US effusion, only 2 were considered clinically involved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>Using US findings as the \u201cgold standard,\u201d clinical examination of the ankle in children with JIA was found to be inadequate in identifying the structures involved. US assessment prior to any glucocorticoid injection should be considered to improve the outcome. A prospective study comparing the outcome following clinical- versus US-guided ankle joint injection should be undertaken, to confirm our findings.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.091262","type":"journal-article","created":{"date-parts":[[2010,9,15]],"date-time":"2010-09-15T20:50:12Z","timestamp":1284583812000},"page":"2409-2414","source":"Crossref","is-referenced-by-count":67,"title":["Prospective Evaluation of Clinical and Ultrasound Findings in Ankle Disease in Juvenile Idiopathic Arthritis: Importance of Ankle Ultrasound"],"prefix":"10.3899","volume":"37","author":[{"given":"LAURA","family":"PASCOLI","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"STEPHEN","family":"WRIGHT","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CATHERINE","family":"McALLISTER","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MADELEINE","family":"ROONEY","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2010,9,15]]},"reference":[{"key":"2018112909250891000_37.11.2409.1","first-page":"1520","article-title":"Worldwide prevalence of juvenile arthritis: why does it vary so much?","volume":"29","author":"Manners","year":"2002","journal-title":"J Rheumatol"},{"key":"2018112909250891000_37.11.2409.2","first-page":"390","article-title":"International League of Associations for Rheumatology. Classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001","volume":"31","author":"Petty","year":"2004","journal-title":"J Rheumatol"},{"key":"2018112909250891000_37.11.2409.3","first-page":"1382","article-title":"Radiographic and clinical outcome in early juvenile rheumatoid arthritis and juvenile spondyloarthropathy: a 3-year prospective study","volume":"33","author":"Selvaag","year":"2006","journal-title":"J Rheumatol"},{"key":"2018112909250891000_37.11.2409.4","first-page":"643","article-title":"Intra-articular steroids in radiologically confirmed tarsal and hip synovitis of juvenile idiopathic arthritis","volume":"22","author":"Tynj\u00e4l\u00e4","year":"2004","journal-title":"Clin Exp Rheumatol"},{"key":"2018112909250891000_37.11.2409.5","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keg358"},{"key":"2018112909250891000_37.11.2409.6","first-page":"2507","article-title":"Comparison of the intraarticular effectiveness of triamcinolone hexacetonide and triamcinolone acetonide in treatment of juvenile rheumatoid arthritis","volume":"31","author":"Eberhard","year":"2004","journal-title":"J Rheumatol"},{"key":"2018112909250891000_37.11.2409.7","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/36.11.1214"},{"key":"2018112909250891000_37.11.2409.8","first-page":"2330","article-title":"Benefit of intraarticular corticosteroid injection under fluoroscopic guidance for subtalar arthritis in juvenile idiopathic arthritis","volume":"33","author":"Beukelman","year":"2006","journal-title":"J Rheumatol"},{"key":"2018112909250891000_37.11.2409.9","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keh313"},{"key":"2018112909250891000_37.11.2409.10","first-page":"123","article-title":"Intraarticular hip treatment with triamcinolone hexacetonide in juvenile chronic arthritis","volume":"40","author":"Boehnke","year":"1994","journal-title":"Acta Univ Carol Med (Praha)"},{"key":"2018112909250891000_37.11.2409.11","doi-asserted-by":"publisher","DOI":"10.1080\/08035250310006700"},{"key":"2018112909250891000_37.11.2409.12","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-007-0525-9"},{"key":"2018112909250891000_37.11.2409.13","first-page":"995","article-title":"Intraarticular triamcinolone in juvenile idiopathic arthritis","volume":"45","author":"Unsal","year":"2008","journal-title":"Ind Pediatr"},{"key":"2018112909250891000_37.11.2409.14","doi-asserted-by":"publisher","DOI":"10.1002\/art.21384"},{"key":"2018112909250891000_37.11.2409.15","first-page":"700","article-title":"Usage of intra-articular corticosteroid injections for the treatment of juvenile idiopathic arthritis: a survey of pediatric rheumatologists in the United States and Canada","volume":"26","author":"Beukelman","year":"2008","journal-title":"Clin Exp Rheumatol"},{"key":"2018112909250891000_37.11.2409.16","first-page":"2696","article-title":"A subgroup-specific evaluation of the efficacy of intraarticular triamcinolone hexacetonide in juvenile chronic arthritis","volume":"27","author":"Breit","year":"2000","journal-title":"J Rheumatol"},{"key":"2018112909250891000_37.11.2409.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2008.08.007"},{"key":"2018112909250891000_37.11.2409.18","first-page":"629","article-title":"Ultrasonography of the hip in the evaluation of children with seronegative juvenile rheumatoid arthritis","volume":"29","author":"Friedman","year":"2002","journal-title":"J Rheumatol"},{"key":"2018112909250891000_37.11.2409.19","doi-asserted-by":"publisher","DOI":"10.1136\/ard.62.3.242"},{"key":"2018112909250891000_37.11.2409.20","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1148\/radiology.190.2.8284388","article-title":"Juvenile rheumatoid arthritis of the knee: evaluation with US","volume":"190","author":"Sureda","year":"1994","journal-title":"Radiology"},{"key":"2018112909250891000_37.11.2409.21","doi-asserted-by":"publisher","DOI":"10.1007\/s002470050554"},{"key":"2018112909250891000_37.11.2409.22","doi-asserted-by":"publisher","DOI":"10.1007\/s002470100474"},{"key":"2018112909250891000_37.11.2409.23","doi-asserted-by":"publisher","DOI":"10.1007\/s003930170063"},{"key":"2018112909250891000_37.11.2409.24","doi-asserted-by":"publisher","DOI":"10.1016\/S1297-319X(01)00269-X"},{"key":"2018112909250891000_37.11.2409.25","first-page":"643","article-title":"Intra-articular steroids in radiologically confirmed tarsal and hip synovitis of juvenile idiopathic arthritis","volume":"22","author":"Tynj\u00e4l\u00e4","year":"2004","journal-title":"Clin Exp Rheumatol"},{"key":"2018112909250891000_37.11.2409.26","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-007-0482-7"},{"key":"2018112909250891000_37.11.2409.27","doi-asserted-by":"publisher","DOI":"10.1007\/BF02012732"},{"key":"2018112909250891000_37.11.2409.28","first-page":"1820","article-title":"Ultrasonography in the early diagnosis of hip joint involvement in juvenile rheumatoid arthritis","volume":"24","author":"Fedrizzi","year":"1997","journal-title":"J Rheumatol"},{"key":"2018112909250891000_37.11.2409.29","doi-asserted-by":"crossref","first-page":"367","DOI":"10.3109\/17453678508994349","article-title":"Ultrasonography in hip disease in children","volume":"56","author":"Kallio","year":"1985","journal-title":"Acta Orthop Scand"},{"key":"2018112909250891000_37.11.2409.30","doi-asserted-by":"crossref","first-page":"295","DOI":"10.3109\/17453678608994395","article-title":"Sonography, arthroscopy, and intracapsular pressure in juvenile chronic arthritis of the hip","volume":"57","author":"Rydholm","year":"1986","journal-title":"Acta Orthop Scand"},{"key":"2018112909250891000_37.11.2409.31","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-007-0148-1"},{"key":"2018112909250891000_37.11.2409.32","doi-asserted-by":"publisher","DOI":"10.1002\/art.24313"},{"key":"2018112909250891000_37.11.2409.33","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-007-0438-9"},{"key":"2018112909250891000_37.11.2409.34","first-page":"1079","article-title":"Ultrasonography in the evaluation of wrist swelling in children","volume":"16","author":"Goldenstein","year":"1989","journal-title":"J Rheumatol"},{"key":"2018112909250891000_37.11.2409.35","doi-asserted-by":"publisher","DOI":"10.1002\/art.22533"},{"key":"2018112909250891000_37.11.2409.36","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.080508"},{"key":"2018112909250891000_37.11.2409.37","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200112)44:12<2932::AID-ART481>3.0.CO;2-3"},{"key":"2018112909250891000_37.11.2409.38","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-8389(05)70048-8"},{"key":"2018112909250891000_37.11.2409.39","first-page":"2131","article-title":"Ultrasound guided injections in rheumatology","volume":"27","author":"Koski","year":"2000","journal-title":"J Rheumatol"},{"key":"2018112909250891000_37.11.2409.40","doi-asserted-by":"publisher","DOI":"10.1053\/sarh.2001.19822"},{"key":"2018112909250891000_37.11.2409.41","doi-asserted-by":"crossref","first-page":"21","DOI":"10.7863\/jum.2001.20.1.21","article-title":"Use of ultrasonographic guidance in interventional musculoskeletal procedures: a review from a single institution","volume":"20","author":"Sofka","year":"2001","journal-title":"J Ultrasound Med"},{"key":"2018112909250891000_37.11.2409.42","first-page":"2209","article-title":"Ultrasound guided versus conventional joint and soft tissue fluid aspiration in rheumatology practice: a pilot study","volume":"29","author":"Balint","year":"2002","journal-title":"J Rheumatol"},{"key":"2018112909250891000_37.11.2409.43","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2003.015081"},{"key":"2018112909250891000_37.11.2409.44","doi-asserted-by":"publisher","DOI":"10.1136\/ard.60.7.641"}],"container-title":["The Journal of Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.3899\/jrheum.091262","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,11,29]],"date-time":"2018-11-29T12:49:09Z","timestamp":1543495749000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.jrheum.org\/lookup\/doi\/10.3899\/jrheum.091262"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,9,15]]},"references-count":44,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2010,11,1]]},"published-print":{"date-parts":[[2010,11]]}},"alternative-id":["10.3899\/jrheum.091262"],"URL":"https:\/\/doi.org\/10.3899\/jrheum.091262","relation":{},"ISSN":["0315-162X","1499-2752"],"issn-type":[{"value":"0315-162X","type":"print"},{"value":"1499-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,9,15]]}}}