Ultrasound

• Musculoskeletal ultrasound (MSUS) is sensitive to early changes in JIA and helps to identify which structures are involved in a clinically swollen joint.
• Ultrasound can differentiate between joint effusions, synovial hypertrophy, synovitis, enthesitis, tendonitis and tenosynovitis.
• Ultrasound is inexpensive, easy to perform and is well tolerated by most children, without the need for general anaesthesia. 
• MSUS findings are operator-dependent. Standardising procedures and comparing findings between observers is important. 
• A review of the use of MSUS in JIA is suggested.