Correlation between osteochondral changes depicted by magnetic resonance imaging and disease progression.
OBJECTIVE
To determine the consequences of the chronic use of systemic corticosteroids in children with juvenile rheumatoid arthritis by means of evaluating osteochondral effects depicted by magnetic resonance imaging.


METHODS
We reviewed clinical and magnetic resonance imaging findings in 69 children (72 knees) with juvenile rheumatoid arthritis. Two groups were studied. Group I: 34 (49.3%) children had previous or current use of systemic corticotherapy (22 girls; 12 boys; mean age: 11.3 years; mean disease duration: 5.9 years; mean corticotherapy duration: 2.9 years; mean cumulative dose of previous corticosteroids: 5000 mg); Group II: 35 (50.7%) children had no previous use of corticosteroids (27 girls; 8 boys; mean age: 11.7 years; mean disease duration: 5.3 years). The groups were compared statistically.


RESULTS
In the group that had received corticotherapy (Group I), osteochondral abnormalities were significantly correlated to long-standing disease (>3.5 years; p<0.001). This correlation was not found in the group that had no previous history of corticotherapy (Group II). No correlations were established between median dose of corticosteroids and magnetic resonance imaging findings.


CONCLUSIONS
It is important to further investigate the long-term intra-articular effects of systemic corticotherapy to ensure that the side effects of the aggressive therapy will not be more harmful for the joints than the symptoms suffered over the natural course of the disease.
Doria
A S
AS
Hospital das Clínicas, Faculty of Medicine, University of São Paulo, Brazil.
Kiss
M H
MH
Sallum
A M
AM
Lotito
A P
AP
Naka
E N
EN
Castro
C C
CC
Cerri
G G
GG
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D001171:Arthritis, Juvenile / Q000188:drug therapy*; D001847:Bone Diseases / Q000139:chemically induced / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006801:Humans; D007717:Knee; D008279:Magnetic Resonance Imaging; D008297:Male; D013997:Time Factors
D000305:Adrenal Cortex Hormones