Evidence map›Paper›PMID 29132381›Full record

ArticlePediatric rheumatology online journal2017

Patients with juvenile idiopathic arthritis in clinical remission with positive power Doppler signal in joint ultrasonography have an increased rate of clinical flare: a prospective study.

Vanessa Bugni Miotto E Silva, Sônia de Aguiar Vilela Mitraud, Rita Nely Vilar Furtado, Jamil Natour, Claudio Arnaldo Len, Maria Teresa de Sande E Lemos Ramos Ascensão Terreri

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric rheumatology online journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05545098 (The Role of Musculoskeletal Ultrasound Versus Serum Survivin and Lubricin Levels in Evaluation of Disease Activity in Juvenile Idiopathic Arthritis), which is not on this map. Cited by 27 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 1 pooled it
2.7field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05545098 unknown statusnot on this mapstarted 2022, after this paper: background citation

The Role of Musculoskeletal Ultrasound Versus Serum Survivin and Lubricin Levels in Evaluation of Disease Activity in Juvenile Idiopathic Arthritis

TypeobservationalSponsorAssiut UniversityRan2022 to 2024Enrolled106ConditionsJuvenile Idiopathic Arthritis
3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.

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  12. Sonographic and Disease Activity Findings Related With Medication Change in JIA: A Historical Cohort Study.Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Vanessa Bugni Miotto E SilvaPediatric Rheumatology Unit, Allergy, Immunology and Rheumatology Division, Pediatric Department, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Borges Lagoa Street, 802, Vila Clementino, São Paulo, SP Zip code 04038-001, Brazil. vanbugni@hotmail.com.
Sônia de Aguiar Vilela MitraudImaging Diagnostics Department, UNIFESP/EPM, São Paulo, Brazil.
Rita Nely Vilar FurtadoRheumatology Division, Department of Medicine, UNIFESP/EPM, São Paulo, Brazil.
Jamil NatourRheumatology Division, Department of Medicine, UNIFESP/EPM, São Paulo, Brazil.
Claudio Arnaldo LenPediatric Rheumatology Unit, Allergy, Immunology and Rheumatology Division, Pediatric Department, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Borges Lagoa Street, 802, Vila Clementino, São Paulo, SP Zip code 04038-001, Brazil.
Maria Teresa de Sande E Lemos Ramos Ascensão TerreriPediatric Rheumatology Unit, Allergy, Immunology and Rheumatology Division, Pediatric Department, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Borges Lagoa Street, 802, Vila Clementino, São Paulo, SP Zip code 04038-001, Brazil.
Universidade Federal de São Paulo · BR

Funding

Conselho Nacional de Desenvolvimento Científico e Tecnológico 303752/2015-7Coordenação de Aperfeiçoamento de Pessoal de Nível Superior 1222417Fundação de Amparo à Pesquisa do Estado de São Paulo 2010/50128-5
6 · The paper itself

Abstract

backgroundUltrasonography (US) studies carried out on joints of juvenile idiopathic arthritis (JIA) patients in clinical remission demonstrate the presence of subclinical synovitis. The significance of subclinical synovitis and the positive power Doppler (PD) signal on US in JIA in clinical remission is not well understood. The objectives of this study were to assess whether the changes detected by US in patients with JIA in clinical remission can predict disease flare and to evaluate factors associated with flare and joint damage over 30 months of follow-up.

methodsA prospective study was performed with clinical and ultrasound evaluation in 34 joints of JIA patients in clinical remission. Clinical evaluation including physical exam, functional capacity and inflammatory markers was performed at baseline and every six months thereafter, for a total period of 30 months. US evaluation included presence of synovitis, PD signal and erosion at baseline and every 12 months thereafter. Subclinical synovitis was defined when there was synovitis with or without positive PD signal in US joints of patients in clinical remission. Flare was defined as any joint presenting clinical arthritis requiring therapy modification.

resultsWe evaluated a total of 35 patients, 28 (80%) girls, 14 (40%) persistent oligoarticular subtype, 12 (34.3%) oligoarticular extended and 9 (25.7%) polyarticular and 26 (74.3%) in remission on medication. Twenty (57.1%) patients flared. The risk of flare was five times higher in patients with positive PD signal and 14 times higher in patients in remission on medication. Regarding the assessment of joints after 6 months and 12 months of US evaluation, 70/3162 (2.2%) joints and 80/2108 (3.8%) joints flared, respectively. Joints with subclinical synovitis with positive PD signal flared more after 6 and 12 months. Twenty five of 2108 (1.2%) joints showed erosion over time. Joints with subclinical synovitis with or without positive PD signal showed more erosion.

conclusionsPatients in remission on medication with subclinical synovitis with positive PD signal on US have a higher risk of flare, therefore they should be monitored closely during treatment. In the same way, joints with subclinical synovitis with or without positive PD signal should be monitored due to the risk of flare and joint damage.

Indexed as

AdolescentArthritis, JuvenileChildFemaleFollow-Up StudiesHumansJointsLongitudinal StudiesMaleProspective StudiesSurvival AnalysisSymptom Flare UpSynovitisUltrasonography, DopplerFlareJuvenile arthritisPower DopplerSynovitisUltrasonography

Identifiers

PMID29132381
PMCPMC5683235
OpenAlexW2769598405

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.