Magnetic resonance imaging of the knee joint in juvenile idiopathic arthritis

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

Juvenile idiopathic arthritis of the knee: is contrast needed to score disease activity when using an augmented MRI protocol comprising PD-weighted sequences?

“…The synovial border is blurred by the process of diffusion of the contrast agent into the synovial fluid. Significant differences in synovial thickness measurements have been found dependent on the acquisition time of post-contrast images [ 17 , 18 ]. Mean scores for synovial thickness and enhancement were reported significantly higher when based on late post-contrast images as compared to early post-contrast images in recent literature by Barendregt et al [ 34 ] and Rieter et al [ 35 ]: standardization of post-contrast image acquisition timing might thus be necessary to achieve reproducible results.…”

“…Various MRI scoring systems have been developed to assess disease and to monitor activity on MR imaging including the juvenile arthritis MRI scoring (JAMRIS) system for the knee and the international prophylaxis study group (IPSG) scores [13][14][15][16]. In both MRI scoring systems, features such as cartilage lesions and bone involvement (marrow edema and erosions, cysts) are objectified in a point score according to pathological findings; assessment of synovial membrane thickness as a measure of synovitis is yet another crucial point [17].…”

Advanced Imaging of Gout and Other Inflammatory Diseases Around the Knee

“…MRI also offers a superior assessment of the menisci and reveals frequent infiltration and damage by synovium in RA, whereas JIA patients often present with meniscal hypoplasia. 25 Osteophytes and subchondral sclerosis stand out as distinctive features of OA that may manifest secondarily to inflammatory arthritis.…”

Surgical Treatment of Juvenile Idiopathic Arthritis in the Era of Novel Drug Therapies

“…MRI is useful for assessing the level and extent of synovitis and joint damage [9][10][11][12]. Before endotracheal intubation, X-rays with lateral extension and flexion of the cervical spine should be performed so that the instability of the occipital joint is not underestimated [13].…”