Emergence of Musculoskeletal Ultrasound Use in Pediatric Rheumatology.

PURPOSE OF REVIEW: To summarize recent international efforts on standardization and validation of pediatric musculoskeletal ultrasound and determine its role in diagnosis and monitoring of disease in pediatric rheumatology.

RECENT FINDINGS: Over the past decade, significant progress has been made on building the evidence base for musculoskeletal ultrasound in pediatric rheumatology. This includes the clear definition of the sonographic appearance of the normal pediatric joint and enthesis on ultrasonography, definitions for pathology, and the establishment of a specific scoring system for the pediatric knee. Ultrasonography has been shown to have an important role in the detection of subclinical synovitis and can predict flares in children considered to be in remission clinically. Musculoskeletal ultrasound is likely going to play an important role in complementing the clinical exam especially in juvenile idiopathic arthritis. Given the powerful therapeutic tools available, it will support early diagnosis and precisely determine remission status. In a treat to target approach, it will greatly help to define the targets that need to be reached.