title: Radiographic progression in children with polyarticular juvenile rheumatoid arthritis: a pilot study.
abstract: OBJECTIVE
  To assess disease progression on hand/wrist x rays from children with polyarticular juvenile rheumatoid arthritis.
  
  
  METHODS
  Initial and subsequent films of 13 white children (10 girls) were read blind by a paediatric radiologist for the presence of joint space narrowing (JSN), erosions, and relative carpal length (RCL).
  
  
  RESULTS
  One child had subcutaneous nodules; one (of 11) was rheumatoid factor positive; six were ANA positive. Median age at diagnosis was 10.7 years (2.5 to 15.9). Median number of involved joints (swelling, pain, or decreased range of motion) at diagnosis was 16 (6 to 33). Four initial x rays had either erosions or JSN. Subsequent x rays were done at (median) 13.3 (8.3 to 24.9) months after initial x rays. One of 10 subsequent x rays had shortened RCL, and six of 13 were worse than the initial ones. Four of these developed new erosions, one had increased number of erosions, and one developed new JSN.
  
  
  CONCLUSIONS
  About half the children with polyarticular juvenile rheumatoid arthritis will have evidence of radiographic progression within two years after diagnosis. Thus newly diagnosed children are at high risk of substantial joint destruction and potential disability, emphasising the need for prompt treatment.
authors.affiliation: Division of Rheumatology, Mayo Clinic, Rochester, MN 55905, USA. mason.thomas@mayo.edu
authors.forename: T
authors.initials: T
authors.lastname: Mason
authors.forename: A M
authors.initials: AM
authors.lastname: Reed
authors.forename: A M
authors.initials: AM
authors.lastname: Nelson
authors.forename: K B
authors.initials: KB
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D018501:Antirheumatic Agents / Q000008:administration & dosage; D001171:Arthritis, Juvenile / Q000000981:diagnostic imaging* / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006225:Hand / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011379:Prognosis; D011859:Radiography; D012720:Severity of Illness Index; D014955:Wrist Joint / Q000000981:diagnostic imaging
chemical_list: D018501:Antirheumatic Agents