title: Rare presentation of polyarticular juvenile idiopathic arthritis and the role of the radiograph in initial diagnosis.
abstract: BACKGROUND
  Polyarticular disease affects one-third of all juvenile idiopathic arthritides. It affects girls twice as much as boys. It usually involves peripheral joints throughout the course of disease. It is unusual for cervical spine involvement to be the presenting symptoms of RF negative polyarthritis.
  
  
  METHODS
  This is the case of RF-negative polyarticular juvenile idiopathic arthritis that was reported with six-week history of neck pain, torticollis and left knee effusion. The case was sent to the radiology department from primary care. Despite the fact that the symptoms occurred quite recently, on initial radiograph significant cervical spine inflammation and damage were revealed.
  
  
  CONCLUSIONS
  This case highlights the importance of early recognition of neck involvement in juvenile idiopathic arthritis as well as significance of close liaison between radiology and paediatric rheumatology. It also highlights the possible role of cervical spine imaging in all children with juvenile idiopathic arthritis.
authors.affiliation: Department of Paediatric Rheumatology, Bristol Children's Hospital, UK.
authors.forename: Ma
authors.initials: M
authors.lastname: Khan
authors.affiliation: Department of Paediatric Radiology, Bristol Children's Hospital, UK.
authors.forename: M
authors.initials: M
authors.lastname: Thyagiarajan
authors.affiliation: Department of Radiology, Royal United Hospital Bath NHS Trust, UK.
authors.forename: M
authors.initials: M
authors.lastname: Laugharne
authors.affiliation: Department of Paediatric Rheumatology, Bristol Children's Hospital, UK jacqui.clinch@uhbristol.nhs.uk.
authors.forename: J
authors.initials: J
authors.lastname: Clinch
mesh_terms: D001171:Arthritis, Juvenile / Q000150:complications / Q000000981:diagnostic imaging*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology; D002648:Child; D003937:Diagnosis, Differential; D004487:Edema / Q000209:etiology; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D019547:Neck Pain / Q000209:etiology*; D011859:Radiography
keywords: Juvenile idiopathic arthritis; cervical spine; paediatrics; radiology