ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 0419

Ultrasound-Guided Synovial Biopsy in Children and Adolescents with Juvenile Arthritis: Initial Results

Patricia Vega-Fernandez1, Kelly Rogers2, Megan Quinlan-Waters3, Sheila Angeles-Han2, Alexei Grom1, Daniel Lovell1, Jennifer Huggins4, Ekemini Ogbu1, Amy Cassedy5, Sara Szabo1, Tracy Ting1, Grant Schulert1, McKenzie Vater6, Hermine Brunner1, Jackeline Rodriguez-Smith1 and Katelyn Banschbach7, 1Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 2Cincinnati Children's Hospital, Cincinnati, OH, 3Cincinnati Children's Hospital Medical Center, CCHMC, 4Cincinnati Children's Medical Center, Cincinnati, OH, 5Cincinnati Children's hospital medical center, cincinnati, OH, 6Cincinnati Children's Hospital Medical Center, Fort Thomas, KY, 7cincinnati Children's hospital, Villa Hills, KY

Meeting: ACR Convergence 2025

Keywords: , , ,

Session Information

Date: Sunday, October 26, 2025

Title: (0387–0429) Pediatric Rheumatology – Clinical Poster I

Session Type: Poster Session A

Session Time: 10:30AM-12:30PM

Background/Purpose: Ultrasound-guided synovial biopsy (USGSB) has been recently implemented for clinical and research purposes in adults with inflammatory arthritis. The current use of USGSB in the pediatric population is very limited. Here we report our USGSB experience at Cincinnati Children’s Hospital Medical Center (CCHMC).

Methods: Children with a diagnosis of Juvenile Idiopathic Arthritis (JIA) that were to receive a clinically indicated therapeutic knee joint injection were eligible for this study. USGSB was approved by the CCHMC IRB, and all patients/parents provided informed consent. At the time of the joint injection, a musculoskeletal ultrasound (MSUS), USGSB and steroid injection of the affected joint was performed by a pediatric rheumatologist. Clinical and procedure data were collected to determine feasibility. Synovial biopsy inflammation was determined by Krenn’s score. To evaluate procedural safety and tolerability, a questionnaire was administered to the patient/family 2-4 days after the procedure.

Results: A total of 34 children [mean age 10 years (SD 5.1)] with JIA were enrolled in this study. The majority of participants had oligoarticular JIA (68%) with the youngest patient in which an USGSB was completed being 2 years old. While 58% (n=20) of the procedures were done in the operative room under general anesthesia, 42% (n=14) were completed in clinic under local anesthesia. The USGSB and steroid injection was completed in all participants. In general, USGSB were well tolerated. One patient developed a subcutaneous hematoma that resolved within 1 week. The median Krenn’s score was 6 (IQR: 4-7). When patients/families were asked about knee joint pain after the USGSB and steroid injection, they reported that the joint pain had improved in 73% of the cases, while 27% felt the pain after the procedure was the same or worse. After the procedure, all participants/family reported feeling glad being a part of the study and 93% (14 of 15 responders) felt that other children could tolerate the biopsy while pain during the procedure is under control. Of note, 2 patients had a repeat biopsy with no complications.

Conclusion: USGSB are safe and well-tolerated in children. USGSB has been successfully implemented for research purposes in children and adolescents with JIA in our center.

Disclosures: P. Vega-Fernandez: None; K. Rogers: None; M. Quinlan-Waters: None; S. Angeles-Han: None; A. Grom: Novartis, 2, 5, Sobi, 2, 5, UpToDate, 9; D. Lovell: AbbVie, 2, Bristol-Myers Squibb(BMS), 2, Canadian Arthritis Society, 12, DSMB memberNIH-NIAMS and NIAID, Canadian Arthritis Society, Novartis, 2; J. Huggins: None; E. Ogbu: Cartesian Therapeutics, 2; A. Cassedy: None; S. Szabo: None; T. Ting: None; G. Schulert: IpiNovoyx, 5, Novartis, 2, SOBI, 2; M. Vater: None; H. Brunner: AbbVie, 2, AstraZeneca-Medimmune, 2, Biogen, 2, Boehringer-Ingelheim, 2, Bristol-Myers Squibb(BMS), 2, Eli Lilly, 2, EMD Serono, 2, F. Hoffmann-La Roche, 2, Genentech, 5, GlaxoSmithKline, 2, Merck, 2, Novartis, 2, Pfizer, 2, 5, Sanofi, 2, UCB, 2; J. Rodriguez-Smith: None; K. Banschbach: None.

To cite this abstract in AMA style:

Vega-Fernandez P, Rogers K, Quinlan-Waters M, Angeles-Han S, Grom A, Lovell D, Huggins J, Ogbu E, Cassedy A, Szabo S, Ting T, Schulert G, Vater M, Brunner H, Rodriguez-Smith J, Banschbach K. Ultrasound-Guided Synovial Biopsy in Children and Adolescents with Juvenile Arthritis: Initial Results [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/ultrasound-guided-synovial-biopsy-in-children-and-adolescents-with-juvenile-arthritis-initial-results/. Accessed .

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/ultrasound-guided-synovial-biopsy-in-children-and-adolescents-with-juvenile-arthritis-initial-results/