title: Radiographic and clinical outcome in early juvenile rheumatoid arthritis and juvenile spondyloarthropathy: a 3-year prospective study.
abstract: OBJECTIVE
  To describe radiographic findings at disease onset and 3-year followup in patients with juvenile rheumatoid arthritis (JRA) and juvenile spondyloarthropathy (JSpA), to assess radiographic progression and its predictors, and to prospectively assess clinical outcome and predictors of persistent disease at 3-year followup.
  
  
  METHODS
  A total of 197 patients with JRA/JSpA were examined every 6 months for 3 years. Radiographic examination was performed at baseline and 3-year followup of knees and ankles (all patients) and of other joints on clinical indication. Remission was defined as minimum 6 months without medication and no clinical signs of active disease.
  
  
  RESULTS
  Radiographic abnormalities were found in 88% of the patients at onset and in 81% after 3 years. Frequency of swelling/osteoporosis decreased and frequency of abnormal growth increased from baseline to followup. Knees, hands, and wrists had most frequently radiographic abnormalities. Radiographic progression occurred in 38% of the patients. Joints with swelling/osteoporosis on radiographs, young age, and a large number of mobility-restricted joints at baseline were predictors of radiographic progression. At 3 years, 26% of the patients were in remission and 75% had been treated with disease-modifying antirheumatic drugs. Reduced well-being, a large number of active joints and negative antinuclear antibody at baseline were predictors of persistent disease after 3 years.
  
  
  CONCLUSIONS
  After 3 years most patients had radiographic abnormalities and persistent disease. Young age, many affected joints, reduced well-being, and negative antinuclear antibody at onset increased the risk of radiographic progression and persistent disease after 3 years.
authors.affiliation: Department of Rheumatology, Rikshospitalet University Hospital, Oslo, Norway. aselvaag@ulrik.uio.no
authors.forename: Anne M
authors.initials: AM
authors.lastname: Selvaag
authors.forename: Berit
authors.initials: B
authors.lastname: Flatø
authors.forename: Knut
authors.initials: K
authors.lastname: Dale
authors.forename: Gunhild
authors.initials: G
authors.lastname: Lien
authors.forename: Odd
authors.initials: O
authors.lastname: Vinje
authors.forename: Anna
authors.initials: A
authors.lastname: Smerdel-Ramoya
authors.forename: Øystein
authors.initials: Ø
authors.lastname: Førre
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D001175:Arthrography; D002648:Child; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012074:Remission Induction; D025242:Spondylarthropathies / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D018501:Antirheumatic Agents