title: Frequency of radiographic damage and progression in individual joints in children with juvenile idiopathic arthritis.
abstract: OBJECTIVE
  To evaluate the presence and progression of radiographic joint damage, as assessed with the adapted Sharp/van der Heijde score (SHS), in individual joints in the hand and wrist in patients with juvenile idiopathic arthritis (JIA) and to compare progression of damage among different JIA categories.
  
  
  METHODS
  A total of 372 radiographs of both wrists and hands obtained at first observation and at last followup visit (after 1-10 years) in 186 children with polyarticular-course JIA were evaluated. All radiographs were scored using the adapted SHS by 2 independent readers. Radiographic assessment included evaluation of joint space narrowing (JSN) and erosions on baseline and last followup radiographs and of progression of radiographic changes from baseline to last followup radiographs.
  
  
  RESULTS
  Both JSN and erosions occurred in all adapted SHS areas. Overall, radiographic damage and progression were more common in the wrist and less common in metacarpophalangeal (MCP) joints. The hamate and capitate areas appeared particularly vulnerable to cartilage loss. Erosions were identified most frequently in the hamate and capitate bones as well as in the second and third metacarpal bases. Patients with extended oligoarthritis were distinctly less susceptible to JSN in hand joints, whereas patients with polyarthritis showed a greater tendency to developing erosions in hand joints.
  
  
  CONCLUSIONS
  Radiographic joint damage and progression in our patients with JIA were seen most commonly in the wrist and less commonly in MCP joints. The frequency and localization of structural abnormalities differed markedly across disease categories.
authors: Istituto Giannina Gaslini, Genova, Italy.
authors: Gabriella
authors: G
authors: Giancane
authors: Silvia
authors: S
authors: Pederzoli
authors: Ximena
authors: X
authors: Norambuena
authors: Maka
authors: M
authors: Ioseliani
authors: Juliana
authors: J
authors: Sato
authors: Maria Chiara
authors: MC
authors: Gallo
authors: Giorgia
authors: G
authors: Negro
authors: Angela
authors: A
authors: Pistorio
authors: Nicolino
authors: N
authors: Ruperto
authors: Alberto
authors: A
authors: Martini
authors: Angelo
authors: A
authors: Ravelli
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D050823:Hand Joints / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D011859:Radiography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014955:Wrist Joint / Q000000981:diagnostic imaging*