Magnetic resonance imaging of the knee joint in juvenile idiopathic arthritis

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Abstract

Juvenile idiopathic arthritis (JIA) is an umbrella term for a group of diseases in children younger than 16 years old lasting six weeks or longer. Synovitis may lead to destructive and irreversible joint changes with subsequent functional impairment. Prompt diagnosis is essential to prevent permanent joint damage and preserve joint functionality. In the course of JIA both the axial and peripheral skeleton may be involved in the inflammatory process, but the knee joint is most frequently affected. New drugs and treatment protocols have forced the need for diagnosis at the earliest possible stage. Magnetic resonance imaging (MRI) allows early detection of lesions and constitutes a superior diagnostic imaging method. Synovitis, tenosynovitis, enthesitis, bursitis, osteitis, cartilage loss, bone cysts, and erosions are lesions diagnosed in JIA, and they can be precisely imaged in MRI.

This article aims to present MRI inflammatory features of the knee in children with JIA based on the literature.

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Most cited references 37

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Cartilage damage in osteoarthritis and rheumatoid arthritis--two unequal siblings.

Thomas Pap, Adelheid Korb-Pap (2015)

Cartilage damage is a key feature of degenerative joint disorders-primarily osteoarthritis (OA)-and chronic inflammatory joint diseases, such as rheumatoid arthritis (RA). Substantial progress has been made towards understanding the mechanisms that lead to degradation of the cartilage matrix in either condition, which ultimately results in the progressive remodelling of affected joints. The available data have shown that the molecular steps in cartilage matrix breakdown overlap in OA and RA. However, they have also, to a great extent, changed our view of the roles of cartilage in the pathogenesis of these disorders. In OA, cartilage loss occurs as part of a complex programme that resembles aspects of embryonic bone formation through endochondral ossification. In RA, early cartilage damage is a key trigger of cellular reactions in the synovium. In a proposed model of RA as a site-specific manifestation of a systemic autoimmune disorder, early cartilage damage in the context of immune activation leads to a specific cellular response within articular joints that could explain not only the organ specificity of RA, but also the chronic nature and perpetuation of the disease.

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Recommendations of the ESSR Arthritis Subcommittee for the Use of Magnetic Resonance Imaging in Musculoskeletal Rheumatic Diseases.

Iwona Sudol-Szopinska, Anne Jurik, Iris Eshed … (2015)

This article presents the recommendations of the European Society of Musculoskeletal Radiology Arthritis Subcommittee regarding the standards of the use of MRI in the diagnosis of musculoskeletal rheumatic diseases. The recommendations discuss (1) the role of MRI in current classification criteria of musculoskeletal rheumatic diseases (including early diagnosis of inflammation, disease follow-up, and identification of disease complications); (2) the impact of MRI on the diagnosis of axial and peripheral spondyloarthritis, rheumatoid arthritis, and juvenile spondyloarthritis; (3) MRI protocols for the axial and peripheral joints; (4) MRI interpretation and reporting for axial and peripheral joints; and finally, (5) methods for assessing MR images including quantitative, semiquantitative, and dynamic contrast-enhanced MRI studies.

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Clinical outcome measures in juvenile idiopathic arthritis

Alessandro Consolaro, Gabriella Giancane, Benedetta Schiappapietra … (2016)

Juvenile idiopathic arthritis (JIA), as a chronic condition, is associated with significant disease- and treatment-related morbidity, thus impacting children’s quality of life. In order to optimize JIA management, the paediatric rheumatologist has begun to regularly use measurements of disease activity developed, validated and endorsed by international paediatric rheumatology professional societies in an effort to monitor the disease course over time and assess the efficacy of therapeutic interventions in JIA patients. A literature review was performed to describe the main outcome measures currently used in JIA patients to determine disease activity status. The Juvenile Disease Activity Score (JADAS), in its different versions (classic JADAS, JADAS-CRP and cJADAS) and the validated definitions of disease activity and response to treatment represent an important tool for the assessment of clinically relevant changes in disease activity, leading more and more to a treat-to-target strategy, based on a tight and thorough control of the patient condition. Moreover, in recent years, increasing attention on the incorporation of patient-reported or parent-reported outcomes (PRCOs), when measuring the health state of patients with paediatric rheumatic diseases has emerged. We think that the care of JIA patients cannot be possible without taking into account clinical outcome measures and, in this regard, further work is required.

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Author and article information

Journal

Journal ID (nlm-ta): Reumatologia

Journal ID (iso-abbrev): Reumatologia

Journal ID (publisher-id): RU

Title: Reumatologia

Publisher: Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie

ISSN (Print): 0034-6233

ISSN (Electronic): 2084-9834

Publication date (Electronic): 23 December 2020

Publication date (Print): 2020

Volume: 58

Issue: 6

Pages: 416-423

Affiliations

[1 ]Department of Radiology, National Institute of Geriatrics, Rheumatology, and Rehabilitation, Warsaw, Poland

[2 ]Developmental Age Rheumatology Clinic and Polyclinic, National Institute of Geriatrics, Rheumatology, and Rehabilitation, Warsaw, Poland

Author notes

Address for correspondence: Emil Michalski, Department of Radiology, National Institute of Geriatrics, Rheumatology, and Rehabilitation, 1 Spartańska St., 02-637 Warsaw, Poland. e-mail: emil.michalski.md@ 123456gmail.com

Article

Publisher ID: 42776

DOI: 10.5114/reum.2020.102007

PMC ID: 7792535

PubMed ID: 33456085

SO-VID: cb28279f-ba55-485e-a261-2e33b7faac4e

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This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

Magnetic resonance imaging of the knee joint in juvenile idiopathic arthritis

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Karger: Neurology and Neuroscience

Most cited references 37

Cartilage damage in osteoarthritis and rheumatoid arthritis--two unequal siblings.

Recommendations of the ESSR Arthritis Subcommittee for the Use of Magnetic Resonance Imaging in Musculoskeletal Rheumatic Diseases.

Clinical outcome measures in juvenile idiopathic arthritis

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