Imaging in Juvenile Idiopathic Arthritis - International Initiatives and Ongoing Work. Conventional Radiography in Juvenile Idiopathic Arthritis: Joint Recommendations from the French Societies for Rheumatology, Radiology and Paediatric Rheumatology. Marteau P, Adamsbaum C, Rossi-Semerano L et al. Rice Bodies in Juvenile Rheumatoid Arthritis. Rheumatoid Factors: Clinical Applications. Juvenile Rheumatoid Arthritis of the Knee: Evaluation with Contrast-Enhanced Color Doppler Ultrasound. Imaging of Juvenile Rheumatoid Arthritis. Radiological Findings in Seropositive Juvenile Chronic Arthritis (Juvenile Rheumatoid Arthritis) with Particular Reference to Progression. Knee in Early Juvenile Rheumatoid Arthritis: MR Imaging Findings. Imaging of Juvenile Idiopathic Arthritis: A Multimodality Approach. Sheybani E, Khanna G, White A, Demertzis J. Surgery only used in advanced disease to improve joint function. Nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids and biologic response modifiers also maye be used. The most commonly used drug is methotrexate. Management includes physical therapy, weight control, nutrition counseling, and drugs. Active synovitis is characterized by enhancement in T1-weighted gadolinium contrast studies. MRI may show synovial hypertrophy, joint effusions and rice bodies 10, as well as osseous and cartilaginous erosions. Knee: Widened intercondylar notch is a sign associated with juvenile idiopathic arthritis (and haemophilic arthropathy and tuberculous arthropathy). Hips: can be common (reported range ~ 35-63% 15), especially with enthesitis-related arthritis and polyarticular subtypes 14 Hepatosplenomegaly may be seen on abdominal radiographs, and pericardial or pleural effusions may be seen on chest radiographs. Plain radiographįindings on x-ray include soft tissue swelling, osteopenia, loss of joint space, erosions, growth disturbances (epiphyseal overgrowth or "ballooning") and joint subluxation.Ĭervical spine radiographs may demonstrate:Īnkylosis, especially of the facet joints There is usually a predilection for large joints rather than small joints. ![]() Imaging shows a varied spectrum of involvement, based on the severity and duration of the disease. Systemic onset JIA (Still disease, not to be confused with adult onset Still disease)Īrthritis may present weeks to months after the onset of systemic symptoms There are several subtypes of juvenile idiopathic arthritis 7,8:Īffected ≤4 joints in the first six months of illness Migratory salmon-colored light pink rash involving the trunk and/or extremities and hepatosplenomegaly are also frequently observed in patients with systemic-onset.Ī proportion of patients have serum rheumatoid factor 9. ![]() In patients with systemic-onset (also known as Still disease), intermittent spiking fevers are typically noted, which helps distinguish juvenile idiopathic arthritis from other diseases such as infection, other inflammatory diseases and malignancy. Symptoms are often worse in the morning but typically persist to some extent throughout the day. ![]() Patients may present with an acute onset of symptoms or a more gradual onset. Oligoarticular or polyarticular arthritis of a duration of six weeks or longer must be present to diagnose juvenile idiopathic arthritis. Females are more affected with F:M = 2:1. By definition, symptoms must start before 16 years of age. The estimated incidence is ~13 per 100,000 per annum 3.
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