Juvenile arthritisImaging Approaches for Evaluating Peripheral Joint Abnormalities in Juvenile Idiopathic Arthritis
Section snippets
Methods
To identify studies of peripheral joint evaluation in patients with JIA, we reviewed electronic databases through PubMed, using terms with free-text words. The search terms were “JIA”, “juvenile chronic arthritis”, “juvenile arthritis”, “juvenile rheumatoid arthritis”, “childhood arthritis”, “joint destruction”, “erosion”, “peripheral joint”, “hand”, “foot”, “radiographs”, “radiographic score”, “scoring system”, “sonography”, “ultrasound”, “Doppler” and “magnetic resonance imaging”. All studies
Assessment of Peripheral Joint Abnormalities in JIA Using Conventional Radiography
The reference standard method for assessing joint damage and treatment efficacy in JIA patients is plain radiography. Preventing or limiting joint destruction is a major treatment goal in JIA. However, no guidelines are available, and controlled trials—even those of new agents such as TNF antagonists—failed to evaluate radiographic progression.
In 1995, Lang and coworkers (24) showed that plain radiography identified early destructive changes in children with systemic-onset JIA. The most common
Acknowledgment
The authors sincerely thank Karen Lambot-Juhan (Pediatric Radiology Department, Necker-Enfants Malades Hospital, Paris, France) for help with the relevant imaging example in Figure 2.
References (64)
- et al.
Juvenile idiopathic arthritis
Lancet
(2007) - et al.
The extended oligoarticular subtype is the best predictor of methotrexate efficacy in juvenile idiopathic arthritis
J Pediatr
(1999) Long-term outcomes and predictors of outcomes for patients with juvenile idiopathic arthritis
Best Pract Res Clin Rheumatol
(2002)- et al.
Radiologic progression in patients with juvenile chronic arthritis treated with methotrexate
J Pediatr
(1998) - et al.
Diagnostic value of radiographs of the hands and feet in early rheumatoid arthritis
Joint Bone Spine
(2002) - et al.
Ultrasound versus MRI in the evaluation of juvenile idiopathic arthritis of the knee
Joint Bone Spine
(2001) - et al.
Imaging of articular disorders in children
Radiol Clin North Am
(2004) - et al.
Long-term outcome and prognosis in oligoarticular-onset juvenile idiopathic arthritis
Arthritis Rheum
(2000) - et al.
The early pattern of joint involvement predicts disease progression in children with oligoarticular (pauciarticular) juvenile rheumatoid arthritis
Arthritis Rheum
(2002) - et al.
Factors affecting articular course in antinuclear antibody-positive juvenile idiopathic arthritis
Arthritis Rheum
(2002)
US findings of metacarpophalangeal joints in children with idiopathic juvenile arthritis
Pediatr Radiol
Use of the Sharp and Larsen scoring methods in the assessment of radiographic progression in juvenile idiopathic arthritis
Arthritis Rheum
Radiological findings in seropositive juvenile chronic arthritis (juvenile rheumatoid arthritis) with particular reference to progression
Ann Rheum Dis
Temporomandibular involvement in juvenile idiopathic arthritis
J Rheumatol
Mandibular condyle lesions related to age at onset and subtypes of juvenile rheumatoid arthritis in 15-year-old children
Scand J Dent Res
Radiologic features in juvenile idiopathic arthritis: a first step in the development of a standardized assessment method
Arthritis Rheum
Adapted versions of the Sharp/van der Heijde score are reliable and valid for assessment of radiographic progression in juvenile idiopathic arthritis
Arthritis Rheum
Magnetic resonance imaging, ultrasonography, and conventional radiography in the assessment of bone erosions in juvenile idiopathic arthritis
Arthritis Rheum
Prognostic factors for radiographic progression, radiographic damage, and disability in juvenile idiopathic arthritis
Arthritis Rheum
Comparison of clinical versus ultrasound-determined synovitis in juvenile idiopathic arthritis
Arthritis Rheum
Ultrasound abnormalities of peripheral joints in juvenile idiopathic arthritis and correlation with clinical findings
Arthritis Rheum
The detection of subclinical synovitis by ultrasound in oligoarticular juvenile idiopathic arthritis: a pilot study
Rheumatology (Oxford)
Comparison of clinical and ultrasonograpic evaluations for peripheral synovitis in juvenile idiopathic arthritis
Semin Arthritis Rheum
MRI assessment of bone marrow changes in children with juvenile idiopathic arthritis: inter and intraobserver variability in a multicenter study
Pediatr Radiol
Development and preliminary validation of a paediatric-targeted MRI scoring system for the assessment of disease activity and damage in juvenile idiopathic arthritis
Ann Rheum Dis
Dynamic contrast-enhanced magnetic resonance imaging in the assessment of disease activity in patients with juvenile idiopathic arthritis
Rheumatology (Oxford)
Quantitative magnetic resonance imaging of the hands and wrists of children with juvenile rheumatoid arthritis
J Rheumatol
Radiologic features of systemic onset juvenile rheumatoid arthritis
J Rheumatol
Growth of children of the same race under different environmental conditions
Science
Value of x-ray films of hand and wrist in human identification
Science
Carpal length in children–a useful measurement in the diagnosis of rheumatoid arthritis and some concenital malformation syndromes
Radiology
Radiological approaches to pediatric joint disease
J Rheumatol Suppl
Cited by (30)
Tumefactive synovial thickening mimicking synovial chondromatosis in the setting of oligoarticular juvenile idiopathic arthritis in a toddler
2020, Radiology Case ReportsCitation Excerpt :In contrast to radiographs, MRI has been shown to be more sensitive for detecting synovitis, a potentially important prognostic indicator, [6,7] as well as bone marrow edema, a potential indicator of future erosions, and an indication to initiate therapy [8]. MRI is also useful for detecting cartilage lesions, and synovial hypertrophy [9]. MRI findings of SC most commonly demonstrate lesions that are hypointense or isointense to muscle on T1 and have high signal intensity on T2, with or without focal areas of low signal intensity [10,11].
Imaging of the limping child
2018, European Journal of RadiologyCitation Excerpt :Contrast-enhanced MRI is the gold standard in the detection of early findings of JIA such as synovial inflammation, tenosynovitis, cartilage damage and bone marrow edema. Furthermore MRI accurately assesses late manifestations of the disease, including bone erosions, joint space narrowing, and enthesitis [69]. At MRI, synovitis is represented by a thickened synovium and is distinguished from adjacent joint fluid by an avid enhacement on early FS post-gadolinium T1-weighted images.
Ultrasound in Arthritis
2017, Radiologic Clinics of North AmericaJuvenile idiopathic arthritis and the temporomandibular joint: A comprehensive review
2016, Journal of Cranio-Maxillofacial SurgeryCitation Excerpt :Following intravenous contrast BME tends to enhance (Meyers and Laor, 2013; Vaid et al., 2014), and is therefore thought to reflect true osteitis rather than increased water content alone (Ostergaard et al., 2003). BME is considered pre-erosive changes to the condyles (Breton et al., 2012). In more advanced stages of TMJ arthritis, morphologic changes, such as a flattened articular eminence (Argyropoulou et al., 2009; Mouterde et al., 2009) and derangement of the condyle (cortical bone thinning, flattening, focal to extensive erosive changes with marked destruction and irregularity of the articular surface) can be seen on MRI.
Juvenile idiopathic arthritis. Current practical imaging assessment with emphasis on magnetic resonance imaging.
2013, Radiologic Clinics of North AmericaCitation Excerpt :To further complicate the matter, the clinical presentation and pattern of joint involvement differs across the subtypes of JIA; for example, progressive joint destruction is more common in the polyarticular subtype.18 Two sites of involvement are worth mentioning in children with JIA: the cervical spine (Fig. 8) and temporomandibular joint, where growth disturbances are most likely to occur.18–21 The 3 main imaging modalities used in the evaluation of JIA are radiographs, ultrasonography (US), and MR imaging.
The authors have no conflicts of interest to disclose.