Overview of the radiology of juvenile idiopathic arthritis (JIA)

Use of the sharp and larsen scoring methods in the assessment of radiographic progression in juvenile idiopathic arthritis

“…Because in younger children the changes in carpal bones and, to a lesser extent, in distal metacarpal epiphyses were seen most frequently as deformity in shape rather than as discrete erosions, these deformities were considered equivalent to bony erosions and were graded on the same scale. This phenomenon is unique to JIA and is likely due to a combination of growth abnormalities, ossification of previous cartilage injury, and true bony erosions (35)(36)(37).…”

Correlation between osteochondral changes depicted by magnetic resonance imaging and disease progression

“…Before the advent of MRI, radiography was the only noninvasive method available for direct visualization of bone changes in joints and was the "gold standard" modality for identification of progression in rheumatoid arthritis [20][21][22][23][24][25] . Since the 1950s, much concern has been expressed about the effects of medication used in this disease which has led to large multicenter trials, such as those comparing the effects of oral steroids Figure 2 -Example of longstanding arthritis (12-year duration) in an 18-year-old girl with polyarticular JRA with no previous use of systemic corticotherapy, represented by post-gadolinium MRI images of (A) an axial T1-weighted SE and (B) an axial fat-suppressed, T1-weighted SE sequence.…”

Magnetic resonance imaging in juvenile idiopathic arthritis: Peculiarities of imaging children

“…But it will not allow you to evaluate acute inflammatory changes or see the cartilage which at pediatric age is a very important component of the skeletal system. 13,14 Similarly it is less sensitive than other image modalities when assessing chronic structural changes, 15 uses ionizing radiation and inter-observer variability in its interpretation is really high. 16 It can be normal at early stages of the disease.…”

“…18 Also the chronic inflammation of the joint, atrophy for disuse and prolonged treatment with corticoids can condition diffuse osteopenia and the development of compression fractures especially vertebral and at the load epiphysis level of lower limbs. 12,13,19 Ultrasound Ultrasound is a cheap, accessible technique for the evaluation of joints in real time. It does not require sedation and allows us to study several joints in a relatively short period of time.…”

“…Its main advantage compared to the simple X-ray is that is can assess acute inflammatory changes. As a matter of fact it is more sensitive than clinical exploration when it comes to finding inflammatory signs in certain joints---especially in the small joints of hands and feet, 20 if high frequency linear transducers are used (12)(13)(14)(15)(16)(17)(18). Similarly because it does not irradiate or require sedation it allows us to do serial studies in an attempt to monitor responses to treatment.…”