Synovial thickening detected on magnetic resonance imaging (MRI) is present in a significant number of children with clinically inactive juvenile idiopathic arthritis (JIA).
To evaluate patient characteristics and disease activity parameters in a cohort of children with clinically inactive JIA, both with and without synovial thickening, in order to clarify the observed discrepancy between clinical and MRI assessments.
We prospectively enrolled 52 clinically inactive JIA patients (median age 13.3 years, 63.5% girls) who underwent MRI of the knee as major target joint in JIA. Children were divided into two groups based on MRI outcome: group 1, with synovial thickening on MRI; and group 2, with no synovial thickening on MRI. We used the Juvenile Arthritis MRI Scoring system to evaluate synovial thickness. We compared patient characteristics and disease activity parameters between the groups.
Synovial thickening on MRI was present in 18 clinically inactive patients (group 1, 34.6%). The age was significantly lower for the patients in group 1 (median 10.7 versus 14.4, P=0.008). No significant differences were observed in any of the other patient characteristics nor the disease activity parameters tested.
Synovial thickening on MRI was present in nearly 35% of the children with clinically inactive JIA. Children with synovial thickening on MRI were significantly younger than those without. This might indicate that younger patients are at risk of subclinical disease activity and under-treatment, although the exact clinical relevance of synovial thickening on MRI has not been determined.
Beukelman T, Patkar NM, Saag KG et al (2011) American College of Rheumatology recommendations for the treatment of juvenile idiopathic arthritis: initiation and safety monitoring of therapeutic agents for the treatment of arthritis and systemic features. Arthritis Care Res 63:465–482 CrossRef
Wallace CA, Giannini EH, Huang B et al (2011) American College of Rheumatology provisional criteria for defining clinical inactive disease in select categories of juvenile idiopathic arthritis. Arthritis Care Res 63:929–936 CrossRef
Guzman J, Burgos-Vargas R, Duarte-Salazar C, Gomez-Mora P (1995) Reliability of the articular examination in children with juvenile rheumatoid arthritis: interobserver agreement and sources of disagreement. J Rheumatol 22:2331–2336 PubMed
Hemke R, van den Berg JM, Nusman CM et al (2017) Contrast-enhanced MRI findings of the knee in healthy children; establishing normal values. Eur Radiol. https://doi.org/10.1007/s00330-017-5067-6
Brown A, Hirsch R, Laor T et al (2012) Do patients with juvenile idiopathic arthritis in clinical remission have evidence of persistent inflammation on 3T magnetic resonance imaging? Arthritis Care Res 64:1846–1854 CrossRef
Gardner-Medwin JM, Killeen OG, Ryder CA et al (2006) Magnetic resonance imaging identifies features in clinically unaffected knees predicting extension of arthritis in children with monoarthritis. J Rheumatol 33:2337–2343 PubMed
Petty RE, Southwood TR, Manners P et al (2004) International league of associations for rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol 31:390–392 PubMed
Wulffraat N, van der Net JJ, Ruperto N et al (2001) The Dutch version of the childhood health assessment questionnaire (CHAQ) and the child health questionnaire (CHQ). Clin Exp Rheumatol 19:S111–S115 PubMed
Ostergaard M, Moller-Bisgaard S (2014) Optimal use of MRI in clinical trials, clinical care and clinical registries of patients with rheumatoid arthritis. Clin Exp Rheumatol 32:S17–S22
Gandjbakhch F, Haavardsholm EA, Conaghan PG et al (2014) Determining a magnetic resonance imaging inflammatory activity acceptable state without subsequent radiographic progression in rheumatoid arthritis: results from a followup MRI study of 254 patients in clinical remission or low disease activity. J Rheumatol 41:398–406 CrossRefPubMed
Hetland ML, Stengaard-Pedersen K, Junker P et al (2010) Radiographic progression and remission rates in early rheumatoid arthritis — MRI bone oedema and anti-CCP predicted radiographic progression in the 5-year extension of the double-blind randomised CIMESTRA trial. Ann Rheum Dis 69:1789–1795 CrossRefPubMed
- Juvenile idiopathic arthritis: magnetic resonance imaging of the clinically unaffected knee
E. Charlotte van Gulik
Mendy M. Welsink-Karssies
J. Merlijn van den Berg
Koert M. Dolman
Anouk M. Barendregt
Charlotte M. Nusman
Taco W. Kuijpers
- Springer Berlin Heidelberg
Neu im Fachgebiet Radiologie
Meistgelesene Bücher aus der Radiologie
Mail Icon II