1 research outputs found
a comparative study with ultrasonography
Background Valid detection of arthritis is essential in differential diagnosis
of joint pain. Indocyanin green (ICG)-enhanced fluorescence optical imaging
(FOI) is a new imaging method that visualizes inflammation in wrist and finger
joints. Objectives of this study were to compare FOI with ultrasonography (US,
by gray-scale (GS) and power Doppler (PD)) and clinical examination (CE) and
to estimate the predictive power of FOI for discrimination between
inflammatory and non-inflammatory juvenile joint diseases. Methods FOI and
GSUS/PDUS were performed in both hands of 76 patients with joint pain (53 with
juvenile idiopathic arthritis (JIA), 23 with non-inflammatory joint diseases).
Inflammation was graded by a semiquantitative score (grades 0–3) for each
imaging method. Joints were defined clinically active if swollen or tender
with limited range of motion. Sensitivity and specificity of FOI in three
phases dependent on ICG enhancement (P1–P3) were analyzed with CE and
GSUS/PDUS as reference. Results For JIA patients, FOI had an overall
sensitivity of 67.3%/72.0% and a specificity of 65.0%/58.8% with GSUS/PDUS as
reference; specificity was highest in P3 (GSUS 94.3%/PDUS 91.7%). FOI was more
sensitive for detecting clinically active joints than GSUS/PDUS (75.2% vs
57.3%/32.5%). In patients with non-inflammatory joint diseases both FOI and US
showed positive (i.e., pathological) findings (25% and 14% of joints). The
predictive value for discrimination between inflammatory and non-inflammatory
joint diseases was 0.79 for FOI and 0.80/0.85 for GSUS/PDUS. Conclusions
Dependent on the phase evaluated, FOI had moderate to good agreement with CE
and US. Both imaging methods revealed limitations and should be interpreted
cautiously. FOI may provide an additional diagnostic method in pediatric
rheumatology. Trial registration Deutsches Register Klinischer Studien
DRKS00012572. Registered 31 July 2017