Abstract：
Synovitis and tenosynovitis are present in juvenile idiopathic arthritis (JIA), both as joint pain and/or inflammation, making them difficult to detect on physical examination. Although ultrasonography (US) allows for discrimination of the 2 entities, only definitions and scoring of synovitis in children have been established. This study was undertaken to produce consensus-based US definitions of tenosynovitis in JIA.
A systematic literature search was performed. Selection criteria included studies focused on US definition and scoring systems for tenosynovitis in children, as well as US metric properties. Through a 2-step Delphi process, a panel of international US experts developed definitions for tenosynovitis components (step 1) and validated them by testing their applicability on US images of tenosynovitis in several age groups (step 2). A 5-point Likert scale was used to rate the level of agreement.
A total of 14 studies were identified. Most used the US definitions developed for adults to define tenosynovitis in children. Construct validity was reported in 86% of articles using physical examination as a comparator. Few studies reported US reliability and responsiveness in JIA. In step 1, experts reached a strong group agreement (>86%) by applying adult definitions in children after one round. After 4 rounds of step 2, the final definitions were validated on all tendons and at all locations, except for biceps tenosynovitis in children <4 years old.
The study shows that the definition of tenosynovitis used in adults is applicable to children with minimal modifications agreed upon through a Delphi process. Further studies are required to confirm our results.
A systematic literature search was performed. Selection criteria included studies focused on US definition and scoring systems for tenosynovitis in children, as well as US metric properties. Through a 2-step Delphi process, a panel of international US experts developed definitions for tenosynovitis components (step 1) and validated them by testing their applicability on US images of tenosynovitis in several age groups (step 2). A 5-point Likert scale was used to rate the level of agreement.
A total of 14 studies were identified. Most used the US definitions developed for adults to define tenosynovitis in children. Construct validity was reported in 86% of articles using physical examination as a comparator. Few studies reported US reliability and responsiveness in JIA. In step 1, experts reached a strong group agreement (>86%) by applying adult definitions in children after one round. After 4 rounds of step 2, the final definitions were validated on all tendons and at all locations, except for biceps tenosynovitis in children <4 years old.
The study shows that the definition of tenosynovitis used in adults is applicable to children with minimal modifications agreed upon through a Delphi process. Further studies are required to confirm our results.
摘要：
在幼年特发性关节炎（JIA）中存在滑膜炎和腱鞘炎，作为关节疼痛和/或炎症，使他们难以检测到的体检（PE）。虽然超声波（美国）允许区分两个实体，仅建立了儿童滑膜炎的定义和评分.
目的：在JIA中产生基于共识的美国腱鞘炎定义。
方法：进行了系统的文献检索。选择标准包括针对儿童腱鞘炎的美国定义和评分系统的研究，以及美国公制属性。通过两步Delphi过程，一个美国国际专家小组制定了腱鞘炎成分的定义(第1步),并通过测试其在多个年龄组的腱鞘炎US图像中的适用性来验证这些定义(第2步).使用5点李克特量表对协议水平进行评分。
结果：确定了14项研究。大多数人使用为成人开发的美国定义来定义儿童腱鞘炎。86%的文章使用比较PE报告了结构效度。很少有研究报告JIA的美国可靠性和响应性。在第1步中，专家通过在一轮后将成人定义应用于儿童，达成了强有力的团体协议（>86％）。在第2步的4轮之后，在所有肌腱和所有位置验证了最终定义，除了4岁以下儿童的肱二头肌腱鞘炎。
结论：研究表明，成人使用的腱鞘炎定义适用于通过Delphi过程达成的最小修改的儿童。需要进一步的研究来证实我们的结果。本文受版权保护。保留所有权利。
目的：在JIA中产生基于共识的美国腱鞘炎定义。
方法：进行了系统的文献检索。选择标准包括针对儿童腱鞘炎的美国定义和评分系统的研究，以及美国公制属性。通过两步Delphi过程，一个美国国际专家小组制定了腱鞘炎成分的定义(第1步),并通过测试其在多个年龄组的腱鞘炎US图像中的适用性来验证这些定义(第2步).使用5点李克特量表对协议水平进行评分。
结果：确定了14项研究。大多数人使用为成人开发的美国定义来定义儿童腱鞘炎。86%的文章使用比较PE报告了结构效度。很少有研究报告JIA的美国可靠性和响应性。在第1步中，专家通过在一轮后将成人定义应用于儿童，达成了强有力的团体协议（>86％）。在第2步的4轮之后，在所有肌腱和所有位置验证了最终定义，除了4岁以下儿童的肱二头肌腱鞘炎。
结论：研究表明，成人使用的腱鞘炎定义适用于通过Delphi过程达成的最小修改的儿童。需要进一步的研究来证实我们的结果。本文受版权保护。保留所有权利。
