Radiological imaging in pediatric rheumatic diseases

Matuszewska, Genowefa; Zaniewicz-Kaniewska, Katarzyna; Włodkowska-Korytkowska, Monika; Smorawińska, Patrycja; Saied, Fadhil; Kunisz, Wojciech; Sudoł‐Szopińska, Iwona

doi:10.12659/pjr.889816

Cited by 7 publications

(3 citation statements)

References 5 publications

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“…Below, we present radiographic pictures of individual entities belonging to the group of juvenile spondyloarthropathies, according to the ESSG classification ( 27 ) . Subsequently, in the second part of that paper, we will discuss the usefulness of US and MRI in the diagnosis of early inflammatory changes in the course of JSpA.…”

Section: Imaging Of Juvenile Spondyloarthritismentioning

confidence: 99%

Imaging of juvenile spondyloarthritis. Part I: Classifications and radiographs

et al. 2017

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Juvenile spondyloarthropathies are manifested mainly by symptoms of peripheral arthritis and enthesitis. By contrast with adults, children rarely present with sacroiliitis and spondylitis. Imaging and laboratory tests allow early diagnosis and treatment. Conventional radiographs visualize late inflammatory lesions and post-inflammatory complications. Early diagnosis is possible with the use of ultrasonography and magnetic resonance imaging. The first part of the article presents classifications of juvenile spondyloarthropathies and discusses their radiographic presentation. Typical radiographic features of individual types of juvenile spondyloarthritis are listed (including ankylosing spondylitis, juvenile psoriatic arthritis, reactive arthritis and arthritis in the course of inflammatory bowel diseases). The second part will describe changes visible on ultrasonography and magnetic resonance imaging. In patients with juvenile spondyloarthropathies, these examinations are conducted to diagnose inflammatory lesions in peripheral joints, tendon sheaths, tendons and bursae. Moreover, magnetic resonance imaging also visualizes early inflammatory changes in the axial skeleton and subchondral bone marrow edema, which is considered an early sign of inflammation.

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Section: Imaging Of Juvenile Spondyloarthritismentioning

confidence: 99%

Imaging of juvenile spondyloarthritis. Part I: Classifications and radiographs

et al. 2017

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“…Early diagnosis of rheumatic disease in children and adolescents is important because of the increasing possibility of applying an appropriate form of comprehensive treatment, including targeted pharmacotherapy that offers the possibility of permanent remission. This is particularly relevant in children, as delaying treatment of rheumatic disease can lead to growth and developmental disorders and permanent disability [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging of the musculoskeletal system in the diagnosis of rheumatic diseases in the pediatric population

Ożga,

Mężyk,

Kmiecik

et al. 2024

Reumatologia

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Magnetic resonance imaging (MRI) of the musculoskeletal system is an examination increasingly performed for suspected juvenile idiopathic arthritis, chronic nonbacterial osteomyelitis and juvenile idiopathic inflammatory myopathies, as well as other rheumatic diseases of developmental age. T1-, T2- and PD-weighted with or without fat suppression or short tau inversion recovery/turbo inversion recovery magnitude (STIR/TIRM) sequences and post-contrast sequences are evaluated to diagnose pathological changes in the synovial membrane, subchondral bone marrow and surrounding soft tissues. Magnetic resonance imaging allows detection of synovitis, tenosynovitis, bursitis, and enthesitis as well as bone marrow edema and soft tissue edema. Several pediatric-specific MRI scoring systems have been developed and validated to standardize and facilitate the assessment of the extent of the inflammatory process and disease activity in MRI. Early detection of inflammatory changes allows the inclusion of comprehensive pharmacotherapy giving the possibility of permanent remission and objective measurement of the effectiveness of treatment.

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“…Juvenile spondyloarthritis has been associated with articular involvement of the lower limbs, but not sternoclavicular involvement. However, the SCJs may be one of the first joints to become involved in juvenile ankylosing spondylitis [13]. A previous case-control study reported 14 patients with juvenile spondyloarthritis accompanied with costosternal pain, six of which had reduced chest expansion [14].…”

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confidence: 99%

Successful treatment in a child with enthesitis-related arthritis involving the sternoclavicular joint: a case report

et al. 2019

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BackgroundAlthough the sternoclavicular joint (SCJ) may be involved in ankylosing spondylitis, rheumatic arthritis, and Behçet’s disease and participates in the systemic inflammatory process of arthritis, it is often neglected during routine rheumatologic clinical examinations. To the best of our knowledge, this is the first study to report etanercept treatment in juvenile idiopathic arthritis (JIA) with SCJ involvement.Case presentationIn this study, we describe an unusual case of a child with juvenile idiopathic arthritis with an initial presentation of sternoclavicular mass. The patient (age, 14 years 10 months) presented with an insidious onset atraumatic swelling of the left SCJ and complained of right hip and bilateral ankle tenderness without an apparent cause. Initial ultrasonography indicated a heterogeneous mass in the left SCJ, while computed tomography identified mild swelling of the left SCJ with a thickened synovial lining, mild bone erosion, and some turbid fluid. The patient ultimately underwent left SCJ arthrotomy, during which tapping of the SCJ revealed 2 cc of yellowish fluid, inflammation and necrosis of tissues within the SCJ. A clear yellow joint fluid was aspirated, and testing revealed a negative culture result. The patient was diagnosed with JIA. The joint tenderness improved and erythrocyte sedimentation rate decreased after administering anti-tumor necrosis factor etanercept. An additional ultrasonography demonstrated that the initial imaging findings have been resolved. At the end of a 2-year follow-up period, the patient was completely symptom-free.ConclusionsJIA with SCJ involvement is an uncommon presentation in adolescents. Etanercept may be a beneficial treatment for SCJ involvement in patients with JIA. The upper limbs showed no signs of limited range of motion during the follow-up period. Further studies are warranted to elucidate the efficacy of etanercept in JIA with sternoclavicular joint involvement.

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Radiological imaging in pediatric rheumatic diseases

Cited by 7 publications

References 5 publications

Imaging of juvenile spondyloarthritis. Part I: Classifications and radiographs

Imaging of juvenile spondyloarthritis. Part I: Classifications and radiographs

Magnetic resonance imaging of the musculoskeletal system in the diagnosis of rheumatic diseases in the pediatric population

Successful treatment in a child with enthesitis-related arthritis involving the sternoclavicular joint: a case report

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