April 2013 Newsletter Using Ultrasound to Examine the Growth Plates of Children with Juvenile Idiopathic Arthritis Karen James, M.D. is working with mentors Bethany Marston, M.D. and David Siegel, M.D., M.P.H. on a study on using ultrasound to examine the growth plates of children with juvenile idiopathic arthritis. There is a growing body of literature in pediatric rheumatology on using joint ultrasound to evaluate children for signs of active inflammation and disease activity possibly requiring treatment modification. Ultrasound is a form of imaging like X-rays, but with no radiation, that can be performed in the office and, unlike MRIs, would not require sedation, making it a more feasible imaging tool for disease surveillance. Much of this research is based on other studies in adult populations with rheumatoid arthritis, however little research has been done evaluating the appearance of the growth plate, which is not part of the adult joint. Dr. James’ study involves taking ultrasound images of the joints of children with asymmetric involvement of the large joints (knees, ankles, wrist, or elbows). Comparison will be made of both the width of the growth plates and the Doppler signal representing vascular flow to see if there is a difference between joints affected by disease and joints unaffected by disease. In the future, this information could be used to see if differences seen on ultrasound are predictive of limb length discrepancies in later years.