Musculoskeletal sonography in juvenile systemic lupus erythematosus

OBJECTIVE To demonstrate the role of sonography in depicting periarticular changes in juvenile systemic lupus erythematosus (SLE) and to find out whether certain tendons in juvenile SLE patients were different from those of healthy controls. METHODS Thirty juvenile SLE patients (27 female, 3 male) were recruited for this study. Sonographic evaluations were performed in the knee, ankle, elbow, wrist, and metacarpophalangeal (MCP) joints on the nondominant sides of the individuals. For comparison, 32 healthy volunteers were included as a control group. RESULTS Knee effusion was observed more frequently in the juvenile SLE group compared with the control group (P = 0.00). When tendon thickness measurements were compared between the groups, flexor and extensor tendons of the third finger (at MCP joint level) of juvenile SLE patients were found to be thinner (P = 0.04 and P = 0.03, respectively). Tendon thickness values did not correlate with disease duration or SLE disease activity index scores (P > 0.05). CONCLUSION The main findings of our study were relevant with 1) increased involvement of the knee, ankle, hand extensor tendons, wrist, elbow, and hand flexor tendons (in decreasing order of frequencies) in juvenile SLE, and 2) decreased extensor/flexor tendon thicknesses in the hands of juvenile SLE patients. Physicians should be aware of the potentially disabling scenario of tendon pathologies. Defining the extent of joint and tendon pathologies in juvenile SLE may guide us in the management of the disease.