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As a result of these findings we are performing a prospective study. Preliminary analysis of the first 15 ankles confirms the clinical overdiagnosis of tibiotalar synovitis and underdiagnosis of tendon involvement. Conclusion In JIA with ankle disease, 39% of cases the main ankle joint was not involved and tenosynovitis, sometimes in isolation, was the dominant finding. This has implications for therapeutic intervention and also for an improved classification of children with JIA especially with ankle involvement.

The correlation between clinical and ultrasonographic findings of ankle disease in JIA