Knee acoustic emissions may help identify patients with juvenile idiopathic arthritis
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Key takeaways:
- Joint acoustic emissions may provide an inexpensive diagnostic approach for JIA.
- An algorithm that was trained to identify knees of patients with JIA had an accuracy of nearly 90%.
Knee acoustic emissions may be an “inexpensive and easy-to-use” biomarker to help differentiate between patients with and without juvenile idiopathic arthritis, according to data published in Pediatric Rheumatology.
“While diagnosing JIA early in its disease process is crucial for disease modification and treatment, multiple diagnostic challenges limit ideal management, including significant shortages of pediatric rheumatologists in the U.S.,” Quentin Goossens, PhD, of the Georgia Institute of Technology, in Atlanta, and colleagues wrote. “Furthermore, no easy-to-use and inexpensive objective measurement exists for monitoring joints affected by JIA in the long term, apart from symptom-based questionnaires that can be affected by subjectivity.”
To investigate the validity of using joint acoustic emissions to identify patients with JIA, Goossens and colleagues analyzed data from patients diagnosed with JIA at the Children’s Healthcare of Atlanta Center for Advanced Pediatrics. Patients with a previously recorded musculoskeletal injury were excluded from the analysis.
The researchers analyzed all knees as separate entities from their pair. Knees were considered active if there was swelling alone, or if the patient was experiencing a limited range of motion. The researchers recorded joint acoustic emissions from each patient during 10 “seated, unloaded flexion-extension cycles,” they wrote. Emissions were recorded and the results were used to train an algorithm to appropriately identify knees of patients with JIA, as well as healthy control knees.
The analysis included a total of 116 participants, of whom 86 had JIA while 30 were healthy controls. Out of the 86 patients with JIA, 43 demonstrated active knee involvement during the study. During testing, the algorithm demonstrated an accuracy of 87.7%. Sensitivity for the testing group was 88.1%, and specificity was 83.3%, according to the researchers. In addition, the joint score distributions for knees with and without JIA were significantly different.
“The presented work demonstrates the feasibility to use [joint acoustic emissions (JAEs)] as a non-invasive digital biomarker for articular health assessment in JIA,” Goossens and colleagues wrote. “The use of JAEs by clinicians in the outpatient setting, therefore, represents a potentially inexpensive and easy-to-use screening or disease monitoring tool to help decrease and quantify disease morbidity caused by JIA.”
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