Development and validation of a Pediatric Internationally agreed UltraSound Hip synovitis protocol (PIUS-hip), by the PReS imaging working party
Authors' conclusion
The Pediatric internationally agreed UltraSound hip synovitis protocol (PIUS-hip) could be limited to one longitudinal scan including B-Mode scoring plus measurement of anterior recess size for maximal sensitivity and specificity for synovitis.
Study context
- Population
- Consecutive juvenile idiopathic arthritis (JIA) patients with ≥ 1 clinically affected hip joint60 patients
- Participants
- 76 vs 32
- Comparison
- Musculoskeletal ultrasound (MSUS) of hips with vs without clinical arthritis in JIA
- Hips with clinical arthritisn = 76
- Hips without clinical arthritisn = 32reference
- Outcome
- Sensitivity and specificity of MSUS (pediatric OMERACT B-Mode and power-Doppler scoring) for detection of hip synovitis
Methodological detailsconsecutive patients, interobserver reliability (Fleiss-Kappa)
- Consecutive patients
- Interobserver reliability (Fleiss-Kappa)
Performance
As reported in the abstract
B-Mode positivity (grade ≥ 1)
| Test or model | Value | Sensitivity | Specificity |
|---|---|---|---|
| Hips with clinical arthritis | 97% | 0.97 (0.93-1.0) | 0.85 (0.74-0.97) |
| Hips without clinical arthritis | 6% |
Value
Hips with clinical arthritis97%
Hips without clinical arthritis6%
Sensitivity
Hips with clinical arthritis0.97 (0.93-1.0)
Hips without clinical arthritis— not stated in the abstract
Specificity
Hips with clinical arthritis0.85 (0.74-0.97)
Hips without clinical arthritis— not stated in the abstract
Further findings
| Outcome | P value |
|---|---|
| Anterior recess size (bone to capsula distance)Significantly wider with clinical arthritis | p-value 0.001 |
Anterior recess size cut-off ≥ 7.2 mm for synovitis
- AUC
- at least 95%
- Sensitivity
- 86%
- Specificity
- 94%
Articular capsula and femoral head cartilage thickness
- Did not differ between patients with and without arthritis
Recess size, internal vs external control groups (n = 449)
- Comparable in the internal and external control groups
Interobserver reliability of B-Mode (BM) and PD positivity (Fleiss-Kappa)
- Kappa (excellent agreement)
- 0.85
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Development and validation of a Pediatric Internationally agreed UltraSound Hip synovitis protocol (PIUS-hip), by the PReS imaging working party. Pediatr Rheumatol Online J. Published 13 August 2025. doi:10.
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