Contrast-enhanced MRI compared with the physical examination in the evaluation of disease activity in juvenile idiopathic arthritis.

Objectives: To assess the value of magnetic resonance imaging (MRI) in discriminating between active and inactive juvenile idiopathic arthritis (JIA) patients and to compare physical examination outcomes with MRI outcomes in the assessment of disease status in JIA patients.Methods: Consecutive JIA p...

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Publicado en:European Radiology Vol. 24; no. 2; pp. 327 - 335
Autores principales: Hemke, Robert, Maas, Mario, van Veenendaal, Mira, Dolman, Koert M, van Rossum, Marion A J, van den Berg, J Merlijn, Kuijpers, Taco W
Formato: research Journal Article
Publicado: Springer Nature Feb2014
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2014
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      pub: Springer Nature
      place: New York, New York
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        atl: Contrast-enhanced MRI compared with the physical examination in the evaluation of disease activity in juvenile idiopathic arthritis.
      aug:
        au:
          Hemke, Robert
          Maas, Mario
          van Veenendaal, Mira
          Dolman, Koert M
          van Rossum, Marion A J
          van den Berg, J Merlijn
          Kuijpers, Taco W
        affil: Department of Radiology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands, r.hemke@amc.nl.
      sug:
        subj:
          Arthritis, Juvenile Rheumatoid Diagnosis
          Contrast Media Diagnostic Use
          Knee Joint Pathology
          Magnetic Resonance Imaging Methods
          Physical Examination Methods
          Adolescence
          Child
          Child, Preschool
          Diagnosis, Differential
          Female
          Prospective Studies
          Human
          Male
          ROC Curve
          Reproducibility of Results
          Retrospective Design
          Severity of Illness Indices
          Adolescent: 13-18 years
          Child: 6-12 years
          Child, Preschool: 2-5 years
          Female
          Male
      ab: Objectives: To assess the value of magnetic resonance imaging (MRI) in discriminating between active and inactive juvenile idiopathic arthritis (JIA) patients and to compare physical examination outcomes with MRI outcomes in the assessment of disease status in JIA patients.Methods: Consecutive JIA patients with knee involvement were prospectively studied using an open-bore MRI. Imaging findings from 146 JIA patients were analysed (59.6% female; mean age, 12.9 years). Patients were classified as clinically active or inactive. MRI features were evaluated using the JAMRIS system, comprising validated scores for synovial hypertrophy, bone marrow oedema, cartilage lesions and bone erosions.Results: Inter-reader reliability was good for all MRI features (intra-class correlation coefficient [ICC] = 0.87-0.94). No differences were found between the two groups regarding MRI scores of bone marrow oedema, cartilage lesions or bone erosions. Synovial hypertrophy scores differed significantly between groups (P = 0.016). Nonetheless, synovial hypertrophy was also present in 14 JIA patients (35.9%) with clinically inactive disease. Of JIA patients considered clinically active, 48.6% showed no signs of MRI-based synovitis.Conclusions: MRI can discriminate between clinically active and inactive JIA patients. However, physical examination is neither very sensitive nor specific in evaluating JIA disease activity compared with MRI. Subclinical synovitis was present in >35% of presumed clinically inactive patients.Key Points: • MRI is sensitive for evaluating juvenile idiopathic arthritis (JIA) disease activity. • Contrast-enhanced MRI can distinguish clinically active and inactive JIA patients. • Subclinical synovitis is present in 35.9 % of presumed clinically inactive patients. • Physical examination is neither sensitive nor specific in evaluating JIA disease activity.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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