A comparison of clinical vs ultrasound determined synovitis in juvenile idiopathic arthritis (JIA)

Methods In 34 patients, the clinician (SMM) assessed 52 joints and computed count of joints with swelling, pain/tenderness, restricted motion and active disease (AD). A global articular severity score (GASS) was obtained by grading symptoms in each joint (0–3 scale) and summing scores. Clinical assessments included physician's and parent's global ratings, functional ability and acute phase reactants. The sonographer (OE) scanned independently the same 52 joints for synovial hypertrophy (SI), synovial fluid (SF) and power Doppler (PD), each graded on a 0– 3 scale. Agreement and correlations were assessed with Cohen's kappa and Spearman's correlation, respectively (>0.4 = moderate agreement/correlation).