MRI versus conventional measures of disease activity and structural damage in evaluating treatment efficacy in juvenile idiopathic arthritis

Malattia, Clara; Consolaro, Alessandro; Pederzoli, Silvia; Madeo, Annalisa; Pistorio, Angela; Mazzoni, M.; Mattiuz, Chiara; Magnano, Gian Michele; Viola, Stefania; Buoncompagni, Antonella; Palmisani, Elena; Hasija, Rachana; Ruperto, Nicolino; Ravelli, Angelo; Martini, Alberto

doi:10.1136/annrheumdis-2011-201049

Cited by 34 publications

(15 citation statements)

References 33 publications

(40 reference statements)

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“…The mean (range) SRM for MRI wrist synovitis was good at 1.27 (0.51 to 1.69) and demonstrated ability to discriminate between different levels of clinical responder categories, whereas the SRM for MRI wrist bone marrow oedema was small at 0.22 19 32 44. Similar levels of SRM have been described for MRI knee synovial hypertrophy (0.68–0.70) and bone marrow oedema (0.15) 45 46.…”

Section: Resultsmentioning

confidence: 99%

“…In general, the rate of JSN exceeds that of erosions and total score 29. When compared with CR, Malattia et al 44 described the relative efficacy of MRI compared with CR erosion score to be <1 at year 1; that is, MRI was less responsive than CR in detecting erosive progression; the fact that cartilage assessment was not included in the MRI scoring systems might explain this result. A study of TMJ condylar changes showed that MRI identified significantly more changes than CR (p≤0.003), and MRI was superior to CR in following condylar changes over time: MRI condylar changes at baseline were found in 58.6% compared with 80% at year 2; CR condylar changes were stable at baseline and year 2 at 30% 52…”

Section: Resultsmentioning

confidence: 99%

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EULAR-PReS points to consider for the use of imaging in the diagnosis and management of juvenile idiopathic arthritis in clinical practice

et al. 2015

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To develop evidence based points to consider the use of imaging in the diagnosis and management of juvenile idiopathic arthritis ( JIA) in clinical practice. The task force comprised a group of paediatric rheumatologists, rheumatologists experienced in imaging, radiologists, methodologists and patients from nine countries. Eleven questions on imaging in JIA were generated using a process of discussion and consensus. Research evidence was searched systematically for each question using MEDLINE, EMBASE and Cochrane CENTRAL. Imaging modalities included were conventional radiography, ultrasound, MRI, CT, scintigraphy and positron emission tomography. The experts used the evidence obtained from the relevant studies to develop a set of points to consider. The level of agreement with each point to consider was assessed using a numerical rating scale. A total of 13 277 references were identified from the search process, from which 204 studies were included in the systematic review. Nine points to consider were produced, taking into account the heterogeneity of JIA, the lack of normative data and consequent difficulty identifying pathology. These encompassed the role of imaging in making a diagnosis of JIA, detecting and monitoring inflammation and damage, predicting outcome and response to treatment, use of guided therapies, progression and remission. Level of agreement for each proposition varied according to the research evidence and expert opinion. Nine points to consider and a related research agenda for the role of imaging in the management of JIA were developed using published evidence and expert opinion.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

EULAR-PReS points to consider for the use of imaging in the diagnosis and management of juvenile idiopathic arthritis in clinical practice

et al. 2015

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“…5 .7) [36] . L'évaluation quantitative du rehaussement dynamique de la syno-viale après injection de gadolinium semble mieux corrélée à l'activité de la maladie et à la symptomatologie clinique des patients que l'étude du volume synovial ; elle peut être utilisée pour le suivi des patients sous traitement [39,[57][58][59]109] ; ■ des érosions ostéocartilagineuses, peu fréquentes en début d'évolution [29,36] . Un hyposignal T1 et T2 et un rehaussement hétérogène de la synoviale s'observent dans les synovites sévères en raison de la présence de fibrine et d'hémosidérine, notamment au centre de la synoviale [36] .…”

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Arthrites juvéniles idiopathiques

Cotten¹,

Mazingue²,

Pruvost³

et al. 2013

Imagerie Musculosquelettique : Pathologies Générales

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“…MRI is a frequently used imaging modality in disease activity assessment of JIA. On MRI, thickened synovium (≥2 mm), which enhances after contrast administration, is considered to represent ongoing inflammation of the synovial membrane (synovitis) because it has been shown to be responsive to treatment [ 8 , 9 ]. Also, as recently published by Hemke et al [ 10 ], the synovial thickness in knees of healthy children does not exceed 1.8 mm.…”

Section: Introductionmentioning

confidence: 99%

Juvenile idiopathic arthritis: magnetic resonance imaging of the clinically unaffected knee

Gulik

Welsink‐Karssies

et al. 2018

Pediatr Radiol

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BackgroundSynovial thickening detected on magnetic resonance imaging (MRI) is present in a significant number of children with clinically inactive juvenile idiopathic arthritis (JIA).ObjectiveTo evaluate patient characteristics and disease activity parameters in a cohort of children with clinically inactive JIA, both with and without synovial thickening, in order to clarify the observed discrepancy between clinical and MRI assessments.Materials and methodsWe prospectively enrolled 52 clinically inactive JIA patients (median age 13.3 years, 63.5% girls) who underwent MRI of the knee as major target joint in JIA. Children were divided into two groups based on MRI outcome: group 1, with synovial thickening on MRI; and group 2, with no synovial thickening on MRI. We used the Juvenile Arthritis MRI Scoring system to evaluate synovial thickness. We compared patient characteristics and disease activity parameters between the groups.ResultsSynovial thickening on MRI was present in 18 clinically inactive patients (group 1, 34.6%). The age was significantly lower for the patients in group 1 (median 10.7 versus 14.4, P=0.008). No significant differences were observed in any of the other patient characteristics nor the disease activity parameters tested.ConclusionSynovial thickening on MRI was present in nearly 35% of the children with clinically inactive JIA. Children with synovial thickening on MRI were significantly younger than those without. This might indicate that younger patients are at risk of subclinical disease activity and under-treatment, although the exact clinical relevance of synovial thickening on MRI has not been determined.

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MRI versus conventional measures of disease activity and structural damage in evaluating treatment efficacy in juvenile idiopathic arthritis

Cited by 34 publications

References 33 publications

EULAR-PReS points to consider for the use of imaging in the diagnosis and management of juvenile idiopathic arthritis in clinical practice

EULAR-PReS points to consider for the use of imaging in the diagnosis and management of juvenile idiopathic arthritis in clinical practice

Arthrites juvéniles idiopathiques

Juvenile idiopathic arthritis: magnetic resonance imaging of the clinically unaffected knee

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