Sonographic Evaluation of Pediatric Localized Scleroderma Preliminary Disease Assessment Measures PDF Print E-mail
Monday, 10 May 2010 20:49
Background: Our earlier work in the ultrasonograpy of localized scleroderma (LS) suggests that altered levels of echogenicity and vascularity can be associated with disease activity. Utrasound is clinically benign and readily available, but can be limited by operator dependence. We present our efforts to standardize image acquisition and interpretation of pediatric LS to better evaluate the correlation between specific sonographic findings and disease activity.

Methods: Several meetings have been held among our multi-center group (LOCUS) to work towards standardizing sonographic technique and image interpretation. Demonstration and experience in image acquisition were conducted at workshop meetings. Following meetings in 2007, an ultrasound measure was developed to standardize evaluation of differences in echogenicity and vascularity. Based upon our initial observations, we have labeled this an ultrasound disease activity measure. This preliminary measure was subsequently evaluated on over 180 scans of pediatric LS lesions.

This review suggested that scoring levels should be expanded to better capture the range of observed differences. The revised levels and their definitions were formulated at a February 2009 workshop meeting. We have also developed assessments for scoring changes in tissue thickness and lesion size to better determine if these parameters aid evaluation of disease state.

Results: We have standardized our protocol for acquiring ultrasound images of pediatric LS lesions. A wide range of sonographic differences has been seen in the dermis, hypodermis, and deep tissue layers of active lesions. Preliminary ultrasound assessments have been generated. The disease activity measure scores for altered levels of echogenicity and vascularity in the lesion, and other assessments score for differences in lesion tissue layer thickness and changes in lesion size.

Conclusions:
We describe the range of sonographic differences found in pediatric LS, and present our efforts to standardize ultrasound acquisition and image interpretation for this disease. We present ultrasound measures that may aid evaluation of disease state. These assessments should be considered a work in progress, whose purpose is to facilitate further study in this area. More studies are needed to assess their validity and reliability.

Login to download your own copy of the full and original article from the link provided below.


 
More articles :

» Study Suggests Link Between Scleroderma, Cancer in Certain Patients

Patients with a certain type of may get cancer and scleroderma simultaneously, Johns Hopkins researchers have found, suggesting that in some diseases, autoimmunity and cancer may be linked.These findings could lead researchers closer to discovering...

» Interleukin-6: A New Therapeutic Target in Scleroderma

Interleukin-6 (IL-6) is a classic pro-inflammatory cytokine critical in mounting an effective immune response. It is secreted by a wide array of cell types; however, its effector cells are more restricted, owing to the fact that very few cells,...

» Calcium Deposits Under the Skin

Numerous health effects or conditions are associated with calcinosis or calcium deposits under the skin. According to the , calcinosis is the medical term for calcium deposits that can form under the skin or in the muscles. Calcium deposits in these...

» The Scleroderma Foundation Announces June as 'Scleroderma Awareness Month'

Dedicated to serving the needs of those whose lives have been impacted by scleroderma through its three-fold mission of support, education and research, the is proud to announce June as "Scleroderma Awareness Month."  During June Scleroderma...

» Testing New Drugs for Early Diffuse Systemic Sclerosis

For patients with the connective tissue disease known as Systemic Sclerosis or – there are few reliable drug treatments. There has been emerging interest in the potential of a class of drugs called (TKI) to ameliorate a major feature of the...

» Collagen Vascular Disease

Connective tissue is a major tissue in our body and is responsible for forming the structure of the body parts. It can be considered as a tissue that forms the framework or matrix of the body. It is made up of two proteins, collagen and elastin....