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Contrast-enhanced MRI features in the early diagnosis of Juvenile Idiopathic Arthritis

OBJECTIVES: To determine whether clinical, laboratory or Magnetic Resonance Imaging (MRI) measures differentiate Juvenile Idiopathic Arthritis (JIA) from other forms of active childhood arthritis. MATERIALS AND METHODS: We prospectively collected data of 80 treatment-naïve patients clinically suspec...

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Autores principales: Hemke, Robert, Kuijpers, Taco W., Nusman, Charlotte M., Schonenberg-Meinema, Dieneke, van Rossum, Marion A. J., Dolman, Koert M., van den Berg, J. Merlijn, Maas, Mario
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4595524/
https://www.ncbi.nlm.nih.gov/pubmed/26002127
http://dx.doi.org/10.1007/s00330-015-3752-x
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author Hemke, Robert
Kuijpers, Taco W.
Nusman, Charlotte M.
Schonenberg-Meinema, Dieneke
van Rossum, Marion A. J.
Dolman, Koert M.
van den Berg, J. Merlijn
Maas, Mario
author_facet Hemke, Robert
Kuijpers, Taco W.
Nusman, Charlotte M.
Schonenberg-Meinema, Dieneke
van Rossum, Marion A. J.
Dolman, Koert M.
van den Berg, J. Merlijn
Maas, Mario
author_sort Hemke, Robert
collection PubMed
description OBJECTIVES: To determine whether clinical, laboratory or Magnetic Resonance Imaging (MRI) measures differentiate Juvenile Idiopathic Arthritis (JIA) from other forms of active childhood arthritis. MATERIALS AND METHODS: We prospectively collected data of 80 treatment-naïve patients clinically suspected of JIA with active non-infectious arthritis of (at least) one knee for <12 months duration. Upon presentation patients underwent clinical and laboratory assessments and contrast-enhanced MRI. MRI was not used as a diagnostic criterion. RESULTS: Forty-four (55 %) patients were clinically diagnosed with JIA, whereas in 36 (45 %) patients the diagnosis of JIA was discarded on clinical or laboratory findings. MRI-based synovitis was present in 27 (61.4 %) JIA patients and in 7 (19.4 %) non-JIA patients (P < 0.001). Five factors (male gender, physician’s global assessment of overall disease activity, joints with limited range of motion, HLA-B27, MRI-based synovitis) were associated with the onset of JIA. In multivariate analysis MRI-based synovitis proved to be independently associated with JIA (OR 6.58, 95 % CI 2.36-18.33). In patients with MRI-based synovitis, the RR of having JIA was 3.16 (95 % CI 1.6-6.4). CONCLUSIONS: The presence of MRI-based synovitis is associated with the clinical onset of JIA. Physical examination could be supported by MRI, particularly to contribute in the early differentiation of different forms of non-infectious childhood arthritis. KEY POINTS: • Juvenile Idiopathic Arthritis (JIA) is a diagnosis of exclusion. • Differentiating JIA and other forms of childhood arthritis can be difficult. • MRI-techniques have substantially improved evaluation of joint abnormalities in JIA patients. • MRI-based synovitis is significantly associated with the clinical onset of JIA. • MRI could support physical examination in the early differentiation of childhood arthritis.
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spelling pubmed-45955242015-10-09 Contrast-enhanced MRI features in the early diagnosis of Juvenile Idiopathic Arthritis Hemke, Robert Kuijpers, Taco W. Nusman, Charlotte M. Schonenberg-Meinema, Dieneke van Rossum, Marion A. J. Dolman, Koert M. van den Berg, J. Merlijn Maas, Mario Eur Radiol Paediatric OBJECTIVES: To determine whether clinical, laboratory or Magnetic Resonance Imaging (MRI) measures differentiate Juvenile Idiopathic Arthritis (JIA) from other forms of active childhood arthritis. MATERIALS AND METHODS: We prospectively collected data of 80 treatment-naïve patients clinically suspected of JIA with active non-infectious arthritis of (at least) one knee for <12 months duration. Upon presentation patients underwent clinical and laboratory assessments and contrast-enhanced MRI. MRI was not used as a diagnostic criterion. RESULTS: Forty-four (55 %) patients were clinically diagnosed with JIA, whereas in 36 (45 %) patients the diagnosis of JIA was discarded on clinical or laboratory findings. MRI-based synovitis was present in 27 (61.4 %) JIA patients and in 7 (19.4 %) non-JIA patients (P < 0.001). Five factors (male gender, physician’s global assessment of overall disease activity, joints with limited range of motion, HLA-B27, MRI-based synovitis) were associated with the onset of JIA. In multivariate analysis MRI-based synovitis proved to be independently associated with JIA (OR 6.58, 95 % CI 2.36-18.33). In patients with MRI-based synovitis, the RR of having JIA was 3.16 (95 % CI 1.6-6.4). CONCLUSIONS: The presence of MRI-based synovitis is associated with the clinical onset of JIA. Physical examination could be supported by MRI, particularly to contribute in the early differentiation of different forms of non-infectious childhood arthritis. KEY POINTS: • Juvenile Idiopathic Arthritis (JIA) is a diagnosis of exclusion. • Differentiating JIA and other forms of childhood arthritis can be difficult. • MRI-techniques have substantially improved evaluation of joint abnormalities in JIA patients. • MRI-based synovitis is significantly associated with the clinical onset of JIA. • MRI could support physical examination in the early differentiation of childhood arthritis. Springer Berlin Heidelberg 2015-05-23 2015 /pmc/articles/PMC4595524/ /pubmed/26002127 http://dx.doi.org/10.1007/s00330-015-3752-x Text en © The Author(s) 2015 Open Access This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Paediatric
Hemke, Robert
Kuijpers, Taco W.
Nusman, Charlotte M.
Schonenberg-Meinema, Dieneke
van Rossum, Marion A. J.
Dolman, Koert M.
van den Berg, J. Merlijn
Maas, Mario
Contrast-enhanced MRI features in the early diagnosis of Juvenile Idiopathic Arthritis
title Contrast-enhanced MRI features in the early diagnosis of Juvenile Idiopathic Arthritis
title_full Contrast-enhanced MRI features in the early diagnosis of Juvenile Idiopathic Arthritis
title_fullStr Contrast-enhanced MRI features in the early diagnosis of Juvenile Idiopathic Arthritis
title_full_unstemmed Contrast-enhanced MRI features in the early diagnosis of Juvenile Idiopathic Arthritis
title_short Contrast-enhanced MRI features in the early diagnosis of Juvenile Idiopathic Arthritis
title_sort contrast-enhanced mri features in the early diagnosis of juvenile idiopathic arthritis
topic Paediatric
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4595524/
https://www.ncbi.nlm.nih.gov/pubmed/26002127
http://dx.doi.org/10.1007/s00330-015-3752-x
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