Imaging assessment of children presenting with suspected or known juvenile idiopathic arthritis: ESSR-ESPR points to consider.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_FA921B4D606F
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Imaging assessment of children presenting with suspected or known juvenile idiopathic arthritis: ESSR-ESPR points to consider.
Journal
European radiology
Author(s)
Hemke R., Herregods N., Jaremko J.L., Åström G., Avenarius D., Becce F., Bielecki D.K., Boesen M., Dalili D., Giraudo C., Hermann K.G., Humphries P., Isaac A., Jurik A.G., Klauser A.S., Kvist O., Laloo F., Maas M., Mester A., Oei E., Offiah A.C., Omoumi P., Papakonstantinou O., Plagou A., Shelmerdine S., Simoni P., Sudoł-Szopińska I., Tanturri de Horatio L., Teh J., Jans L., Rosendahl K.
ISSN
1432-1084 (Electronic)
ISSN-L
0938-7994
Publication state
Published
Issued date
10/2020
Peer-reviewed
Oui
Volume
30
Number
10
Pages
5237-5249
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Juvenile idiopathic arthritis (JIA) is the most common paediatric rheumatic disease. It represents a group of heterogenous inflammatory disorders with unknown origin and is a diagnosis of exclusion in which imaging plays an important role. JIA is defined as arthritis of one or more joints that begins before the age of 16 years, persists for more than 6 weeks and is of unknown aetiology and pathophysiology. The clinical goal is early suppression of inflammation to prevent irreversible joint damage which has shifted the emphasis from detecting established joint damage to proactively detecting inflammatory change. This drives the need for imaging techniques that are more sensitive than conventional radiography in the evaluation of inflammatory processes as well as early osteochondral change. Physical examination has limited reliability, even if performed by an experienced clinician, emphasising the importance of imaging to aid in clinical decision-making. On behalf of the European Society of Musculoskeletal Radiology (ESSR) arthritis subcommittee and the European Society of Paediatric Radiology (ESPR) musculoskeletal imaging taskforce, based on literature review and/or expert opinion, we discuss paediatric-specific imaging characteristics of the most commonly involved, in literature best documented and clinically important joints in JIA, namely the temporomandibular joints (TMJs), spine, sacroiliac (SI) joints, wrists, hips and knees, followed by a clinically applicable point to consider for each joint. We will also touch upon controversies in the current literature that remain to be resolved with ongoing research. KEY POINTS: • Juvenile idiopathic arthritis (JIA) is the most common chronic paediatric rheumatic disease and, in JIA imaging, is increasingly important to aid in clinical decision-making. • Conventional radiographs have a lower sensitivity and specificity for detection of disease activity and early destructive change, as compared to MRI or ultrasound. Nonetheless, radiography remains important, particularly in narrowing the differential diagnosis and evaluating growth disturbances. • Mainly in peripheral joints, ultrasound can be helpful for assessment of inflammation and guiding joint injections. In JIA, MRI is the most validated technique. MRI should be considered as the modality of choice to assess the axial skeleton or where the clinical presentation overlaps with JIA.
Keywords
Conventional radiography, Diagnostic imaging, Juvenile idiopathic arthritis, Magnetic resonance imaging, Ultrasound computed tomography
Pubmed
Web of science
Open Access
Yes
Create date
14/06/2020 20:59
Last modification date
15/01/2021 7:12
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