Imaging of juvenile idiopathic arthritis. Part I: Clinical classifications and radiographs.
Juvenile idiopathic arthritis is the most common autoimmune systemic disease of the connective tissue affecting individuals at the developmental age. Radiography is the primary modality employed in the diagnostic imaging in order to identify changes typical of this disease entity and rule out other bone-related pathologies, such as neoplasms, posttraumatic changes, developmental defects and other forms of arthritis. The standard procedure involves the performance of comparative joint radiographs in two planes. Radiographic changes in juvenile idiopathic arthritis are detected in later stages of the disease. Bone structures are assessed in the first place. Radiographs can also indirectly indicate the presence of soft tissue inflammation (i.e. in joint cavities, sheaths and bursae) based on swelling and increased density of the soft tissue as well as dislocation of fat folds. Signs of articular cartilage defects are also seen in radiographs indirectly - based on joint space width changes. The first part of the publication presents the classification of juvenile idiopathic arthritis and discusses its radiographic images. The authors list the affected joints as well as explain the spectrum and specificity of radiographic signs resulting from inflammatory changes overlapping with those caused by the maturation of the skeletal system. Moreover, certain dilemmas associated with the monitoring of the disease are reviewed. The second part of the publication will explain issues associated with ultrasonography and magnetic resonance imaging, which are more and more commonly applied in juvenile idiopathic arthritis for early detection of pathological features as well as the disease complications.
Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland; Department of Medical Imaging, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.
Iwona
I
Sudoł-Szopińska
Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
Genowefa
G
Matuszewska
Paediatric Clinic, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
Piotr
P
Gietka
Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
Mateusz
M
Płaza
Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
Marta
M
Walentowska-Janowicz
classifications; juvenile idiopathic arthritis; juvenile spondyloarthropathies; medical imaging; radiography
Lancet. 2007 Mar 3;369(9563):767-78
17336654
Ocul Immunol Inflamm. 2014 Feb;22(1):56-63
24410427
Ann Rheum Dis. 2015 Nov;74(11):1946-57
26245755
Semin Arthritis Rheum. 2011 Oct;41(2):272-8
21377713
J Rheumatol. 2008 Apr;35(4):553-7
18398949
Rheumatology (Oxford). 2010 Jan;49(1):178-85
19995859
Arthritis Rheum. 2003 Dec;48(12 ):3509-17
14674002
Clin Exp Rheumatol. 2003 Sep-Oct;21(5 Suppl 31):S89-93
14969057
Nat Rev Rheumatol. 2011 Jun 07;7(7):416-26
21647204
Arthritis Rheum. 2004 Mar;50(3):901-5
15022333
Semin Arthritis Rheum. 2012 Apr;41(5):698-711
22035628
Arthritis Rheum. 2007 Sep;56(9):3087-95
17763418
AJR Am J Roentgenol. 2009 May;192(5):1209-18
19380543
Rheum Dis Clin North Am. 2007 Aug;33(3):403-40
17936172
Pediatr Radiol. 2007 May;37(5):475-82
17415601
Clin Radiol. 1996 Feb;51(2):99-102
8631182
Arthritis Rheum. 2008 Dec 15;59(12 ):1764-72
19035414
Ann Rheum Dis. 1985 Oct;44(10 ):685-93
4051591
Semin Musculoskelet Radiol. 2015 Sep;19(4):396-411
26583367
Pediatr Radiol. 1999 Feb;29(2):117-23
9933332