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In the past few years the use of musculoskeletal ultrasound (MSUS) in pediatric rheumatology has proven to be better than clinical examination in detecting synovitis. Beside standard power doppler ultrasound (PDUS), vascularization of the tissues can be assessed using 3D/4D PD sonography. Using this technique, we can now assess a virtually reconstructed vascular tree within a volume of interest and can ‘objectively’ determine its vascularization by calculating indices using the specially designed VOCALTM software (Virtual Organ Computer-aided AnaLysis). 3D/4D US is a well established method for determination of accurate vascularity and blood flow in the field of obstetrics and gynecology, but limited data is available in rheumatology patients.

pediatric rheumatology online journal

Virtual 3D/4D vascular sonobiopsy of the knee joint: validation of the method in the JIA patients treated with ia infliximab or triamcinolone hexacetonide