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MRI of the wrist in juvenile idiopathic arthritis: erosions or normal variants? A prospective case-control study

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Abstract

Background

Bony depressions at the wrist resembling erosions are frequently seen on MRI in healthy children. The accuracy of MRI in detecting early bony destruction is therefore questionable. We compared findings on MRI of the wrist in healthy children and those with juvenile idiopathic arthritis (JIA) to investigate markers for true disease.

Materials and methods

We compared the number and localisation of bony depressions at the wrist in 85 healthy children and 68 children with JIA, ages 5–15 years. The size of the wrist was assessed from a radiograph of the wrist performed on the same day as the MRI.

Results

No significant difference in the number of bony depressions in the carpal bones was seen between healthy children and children with JIA at any age. Depressions are found in similar locations in the two groups, except for a few sites, where bony depressions were seen exclusively in the JIA group, particularly at the CMC joints. The wrist was significantly smaller in children with JIA (P < 0.001).

Conclusions

Using adult scoring systems and standard MR sequences in the assessment of bone destruction in children may lead to overstaging or understaging of disease. At present, standard MRI sequences cannot easily be used for assessment of early signs of erosions in children.

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Acknowledgments

We wish to thank Dr. Clarissa Pilkington, Dr. Sandrine Lacassagne and Professor Pierre Quartier for providing the clinical data for the children from Great Ormond Street Hospital and NEM. This study was funded, in part, by a grant from the European Union, Health-e-Child Integrated Project (IST 2004-027749).

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Authors and Affiliations

  1. Department of Radiology, University Hospital North Norway, Tromsø, Norway

    Lil-Sofie Ording Muller, Derk Avenarius & Odd Petter Eldevik

  2. Department of Radiology, Great Ormond Street Hospital for Children, London, UK

    Lil-Sofie Ording Muller, Catherine M. Owens & Karen Rosendahl

  3. Department of Radiology, Homerton University Hospital, London, UK

    Peter Boavida

  4. Department of Radiology, Ospedale Pediatrico Gaslini, Genoa, Italy

    Beatrice Damasio

  5. Department of Rhematology, Ospedale Pediatrico Gaslini, Genoa, Italy

    Clara Malattia

  6. Department of Radiology, Hopital Necker Enfants Malades, Paris, France

    Karen Lambot-Juhan

  7. Department of Radiology, Ospedale Pediatrico Bambino Gesu, Rome, Italy

    Laura Tanturri

  8. Institute of Child Health, UCL, London, UK

    Catherine M. Owens & Karen Rosendahl

  9. Department of Radiology, Haukeland University Hospital, Bergen, Norway

    Karen Rosendahl

  10. Department of Surgical Sciences, University of Bergen, Bergen, Norway

    Karen Rosendahl

  11. Dalsveien 40H, 0775, Oslo, Norway

    Lil-Sofie Ording Muller

Authors
  1. Lil-Sofie Ording Muller
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  2. Peter Boavida
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  3. Derk Avenarius
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  4. Beatrice Damasio
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  5. Odd Petter Eldevik
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  6. Clara Malattia
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  7. Karen Lambot-Juhan
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  8. Laura Tanturri
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  9. Catherine M. Owens
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  10. Karen Rosendahl
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Corresponding author

Correspondence to Lil-Sofie Ording Muller.

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Ording Muller, LS., Boavida, P., Avenarius, D. et al. MRI of the wrist in juvenile idiopathic arthritis: erosions or normal variants? A prospective case-control study. Pediatr Radiol 43, 785–795 (2013). https://doi.org/10.1007/s00247-012-2575-z

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  • DOI: https://doi.org/10.1007/s00247-012-2575-z

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