Imaging of juvenile spondyloarthritis. Part II: Ultrasonography and magnetic resonance imaging

Sudoł‐Szopińska, Iwona; Znajdek, Michał; Gietka, Piotr; Vasilevska-Nikodinovska, Violeta; Patrovic, L; Salapura, Vladka

doi:10.15557/jou.2017.0026

Cited by 7 publications

(5 citation statements)

References 15 publications

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“…Furthermore, a recent retrospective study in a group of 34 children with IBD who underwent magnetic resonance enterography (MRE) for gastrointestinal disease evaluation have shown that ve had radiological signs of SI in ammation at MRE, although no patient complained of musculoskeletal symptoms, nor had pathological ndings at articular examination (37). This is somewhat in line with the observation that MRI is more sensitive in the assessment of in ammatory and destructive changes in JIA and jSpA than physical examination, radiographs or ultrasound (38). With this in mind, our study for the rst time gives some clue that the concomitant in ammation of the gut and sacroiliac joints can be present early in the course of SpA.…”

Section: Discussionmentioning

confidence: 61%

The Increased Levels of Faecal Calprotectin in Children With Active Enthesitis Related Arthritis and Mri Signs of Sacroiliitis: the Results of A Single Centre Cross-Sectional Study in Juvenile Idiopathic Arthritis Patients

Lamot

Miler

Vukojevic

et al. 2020

Preprint

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Background: Enthesitis related arthritis (ErA) is a specific subtype of juvenile idiopathic arthritis (JIA) which is often regarded as an undifferentiated form of juvenile spondyloarthritis (jSpA). Beside the arthritis of the peripheral joints, the crucial features of jSpA include enthesitis and/or arthritis of axial joints. Moreover, in adult onset spondyloarthritis gut is increasingly recognized as origin and/or target of inflammation, while the incidence of gut involvement in ErA patients is still largely unknown. The aim of this study was to assess the fCAL concentration, a surrogate marker of gut inflammation, in patients with various subtypes of JIA and non-inflammatory musculoskeletal conditions and to assess the correlation with various demographic, clinical, laboratory, imaging and treatment characteristics.Methods: This was a cross-sectional study involving 71 patients with various forms of JIA and other noninflammatory musculoskeletal diseases (NI-MSD). Along with detailed clinical and laboratory examination, fCAL and magnetic resonance imaging (MRI) of sacroiliac joints, thoracic and lumbar spine was routinely performed in all ErA patients, as well as in other patients who complained of abdominal and/or back pain, respectively. In all JIA patients, disease activity was measured using the juvenile arthritis (JADAS) or spondyloarthritis (jSpADA) disease activity score. Results: The median concentration of fCAL was highest in ErA subgroup (33.2 mg/kg, p=0.043), with a significant difference between patients with inactive and active disease (20.0 mg/kg vs 57.4 mg/kg, p=0.01), as well as between those with or without MRI signs of SIJ inflammation (22.6 mg/kg vs 54.3 mg/kg, p=0.048). In all patients, the fCAL concentration did not significantly differ among those receiving and not receiving NSAIDs (23 mg/kg vs 20 mg/kg, p=0.18), although weak correlation was found with the duration of the use (r=0.25, p=0.03).Conclusion: The (subclinical) gut inflammation might not be present only in adults with SpA, but also in children with undifferentiated forms of the jSpA, especially with active disease and/or MRI signs of SI inflammation.

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Section: Discussionmentioning

confidence: 61%

The Increased Levels of Faecal Calprotectin in Children With Active Enthesitis Related Arthritis and Mri Signs of Sacroiliitis: the Results of A Single Centre Cross-Sectional Study in Juvenile Idiopathic Arthritis Patients

Lamot

Miler

Vukojevic

et al. 2020

Preprint

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“…Joint damage in JIA results from synovitis with formation of pannus, which, in the so-called outside-in mechanism, destroys cartilage and bone, leading to subchondral erosions, inflammatory cysts, and ankylosis [6]. A similar inflammatory process, osteitis, starts within the subchondral bone marrow and, through the inside-out mechanism, first leads to subchondral cysts formation, with further evolution to erosions and hyaline cartilage damage [9][10][11]. Another location of disease, typical for the juvenile enthesitisrelated arthritis (ERA) subtype of JIA, are tendons, ligaments, and capsule entheses with inflammation (enthesitis) may lead to bone reaction with the formation of cysts and erosions and peri-entheseal soft tissue involvement [12].…”

Section: Introductionmentioning

confidence: 99%

“…Destructive inflammatory lesions developing in the course of JIA include cysts, erosions, joint space narrowing, chondromalacia, ankylosis, and secondary osteoarthritis. Joint inflammation overlapping natural bone growth in juveniles may lead to growth disturbances and developmental disorders [9,10,15].…”

Section: Introductionmentioning

confidence: 99%

Ankle Magnetic Resonance Imaging in Juvenile Idiopathic Arthritis Versus Non-Juvenile Idiopathic Arthritis Patients with Arthralgia

Ostrowska

Gietka

et al. 2022

JCM

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This retrospective case–control study aimed to evaluate whether Magnetic Resonance Imaging (MRI) enables differentiation of ankle arthritis in Juvenile Idiopathic Afrthritis JIA from ankle arthralgia of unknown aetiology in patients clinically suspected of JIA. Forty-four children, at ages 5–16, who underwent MRI of the ankle from January 2016 to March 2021 for clinically suspected active ankle arthritis in the course of JIA were included. MRI findings in both groups—patients with the final diagnosis of JIA and without final diagnosis of JIA—were compared and scored. The sum of the scores of 22 ankle lesions in an individual patient (active, destructive and developmental), so-called the MRI summarized score, was calculated and tested in terms of the most optimal diagnosis of JIA. Interobserver agreement was calculated. Inflammatory features were seen on MRI in 38 out of all the included patients (86%). The most common lesions in both groups were effusion in the tibio-talar joint (68% in JIA and 64% in the arthralgia group) and effusion in subtalar joint (64% in JIA vs. 59% in the arthralgia group). In general, more lesions were identified in the JIA group than in non-JIA. However, only tenosynovitis was significantly more common in the JIA vs. non-JIA group (p = 0.031). The MRI summarized score did not allow for discrimination between ankle arthritis in JIA from non-JIA patients; the best levels of sensitivity (32%), specificity (91%), positive predictive value PPV (78%) and negative predictive value NPV (57%) were achieved only at the cut-off point of 10.

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“…According to EULAR 8 , MRI is the gold standard for the diagnosis of juvenile idiopathic arthritis. Through this examination, it is possible to identify synovial effusion and thickening in early stages, and, in more advanced stages, joint pannus, bone erosions, cartilage thinning and deformity of joint surfaces can be identified 10 …”

Section: Introductionmentioning

confidence: 99%

“…Through this examination, it is possible to identify synovial effusion and thickening in early stages, and, in more advanced stages, joint pannus, bone erosions, cartilage thinning and deformity of joint surfaces can be identified. 10 The temporomandibular joint (TMJ) has been called in the literature the "forgotten joint". 11 Diagnosing TMJ arthritis is challenging as clinical signs are uncharacteristic and disease onset is usually asymptomatic.…”

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confidence: 99%

Diagnosis of juvenile idiopathic arthritis with asymptomatic involvement of the temporomandibular joint: A case report

Ferrazzo

Thomas

Danesi

et al. 2022

Special Care in Dentistry

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Juvenile idiopathic arthritis (JIA) is a broad term that describes a group of heterogeneous rheumatologic diseases, mainly characterized by inflammation in the joints of children and young people up to 16 years of age. Its etiology is still not well understood and the diagnosis, essentially clinical, begins with the exclusion of other joint diseases. When the disease affects the temporomandibular joint, diagnosis is a challenge, as many patients are asymptomatic. The objective of this paper is to present a case of JIA with severe involvement of the temporomandibular joint and to discuss the clinical, radiographic, laboratory findings and the importance of early diagnosis. The lack of diagnosis of active arthritis in the temporomandibular joint in patients with JIA can cause irreversible effects such as micrognathia, malocclusion and reduced maximum mouth opening. Early diagnosis of temporomandibular joint involvement in JIA is important and needs to be investigated early in the clinical manifestation of systemic disease. Laboratory tests and clinical history are important to define treatment and prognosis, but not to predict temporomandibular joint arthritis. Imaging exams are important diagnostic tools to identify morphological changes in soft and hard tissues of the temporomandibular joint.

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Imaging of juvenile spondyloarthritis. Part II: Ultrasonography and magnetic resonance imaging

Cited by 7 publications

References 15 publications

The Increased Levels of Faecal Calprotectin in Children With Active Enthesitis Related Arthritis and Mri Signs of Sacroiliitis: the Results of A Single Centre Cross-Sectional Study in Juvenile Idiopathic Arthritis Patients

The Increased Levels of Faecal Calprotectin in Children With Active Enthesitis Related Arthritis and Mri Signs of Sacroiliitis: the Results of A Single Centre Cross-Sectional Study in Juvenile Idiopathic Arthritis Patients

Ankle Magnetic Resonance Imaging in Juvenile Idiopathic Arthritis Versus Non-Juvenile Idiopathic Arthritis Patients with Arthralgia

Diagnosis of juvenile idiopathic arthritis with asymptomatic involvement of the temporomandibular joint: A case report

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