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Increasing feasibility and patient comfort of MRI in children with juvenile idiopathic arthritis.

Hemke R, van Veenendaal M, Kuijpers TW, van Rossum MA, Maas M - Pediatr Radiol (2012)

Bottom Line: The MRI examination was successfully completed in all 47 children.Reproducibility of the score was good (Cohen kappa, 0.49-0.96).Signs differing among children with active and inactive disease include infrapatellar fat pad heterogeneity and synovial hypertrophy.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands. r.hemke@amc.nl

ABSTRACT

Background: MRI is the most sensitive imaging modality in juvenile idiopathic arthritis (JIA), but has practical limitations. Optimizing the scanning protocol is, therefore, necessary to increase feasibility and patient comfort.

Objective: To determine the feasibility of bilateral non-contrast-enhanced open-bore MRI of knees and to assess the presence of literature-based MRI features in unsedated children with JIA.

Materials and methods: Children were classified into two clinical subgroups: active arthritis (group 1; n = 29) and inactive disease (group 2; n = 18). MRI features were evaluated using a literature-based score, comprising synovial hypertrophy, cartilage lesions, bone erosions, bone marrow changes, infrapatellar fat pad heterogeneity, effusion, tendinopathy and popliteal lymphadenopathy.

Results: The MRI examination was successfully completed in all 47 children. No scan was excluded due to poor image quality. Synovial hypertrophy was more frequent in group 1 (36.2%), but was also seen in 19.4% of the knees in group 2. Infrapatellar fat pad heterogeneity was more prevalent in group 2 (86.1%; P = 0.008). Reproducibility of the score was good (Cohen kappa, 0.49-0.96).

Conclusion: Bilateral non-contrast-enhanced open-bore knee MRI is feasible in the assessment of disease activity in unsedated children with JIA. Signs differing among children with active and inactive disease include infrapatellar fat pad heterogeneity and synovial hypertrophy.

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Proportion of children with JIA showing specific radiological abnormalities. Gray columns for group 1 (active disease) and black columns for group 2 (inactive disease)
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Fig1: Proportion of children with JIA showing specific radiological abnormalities. Gray columns for group 1 (active disease) and black columns for group 2 (inactive disease)

Mentions: The complete MRI examination of both knees was successfully completed by all 47 children, the youngest being 5 years of age. No MRI dataset was excluded due to poor image quality. The presence of the scored MRI features for the respective study groups is depicted in Fig. 1.Fig. 1


Increasing feasibility and patient comfort of MRI in children with juvenile idiopathic arthritis.

Hemke R, van Veenendaal M, Kuijpers TW, van Rossum MA, Maas M - Pediatr Radiol (2012)

Proportion of children with JIA showing specific radiological abnormalities. Gray columns for group 1 (active disease) and black columns for group 2 (inactive disease)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3316772&req=5

Fig1: Proportion of children with JIA showing specific radiological abnormalities. Gray columns for group 1 (active disease) and black columns for group 2 (inactive disease)
Mentions: The complete MRI examination of both knees was successfully completed by all 47 children, the youngest being 5 years of age. No MRI dataset was excluded due to poor image quality. The presence of the scored MRI features for the respective study groups is depicted in Fig. 1.Fig. 1

Bottom Line: The MRI examination was successfully completed in all 47 children.Reproducibility of the score was good (Cohen kappa, 0.49-0.96).Signs differing among children with active and inactive disease include infrapatellar fat pad heterogeneity and synovial hypertrophy.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands. r.hemke@amc.nl

ABSTRACT

Background: MRI is the most sensitive imaging modality in juvenile idiopathic arthritis (JIA), but has practical limitations. Optimizing the scanning protocol is, therefore, necessary to increase feasibility and patient comfort.

Objective: To determine the feasibility of bilateral non-contrast-enhanced open-bore MRI of knees and to assess the presence of literature-based MRI features in unsedated children with JIA.

Materials and methods: Children were classified into two clinical subgroups: active arthritis (group 1; n = 29) and inactive disease (group 2; n = 18). MRI features were evaluated using a literature-based score, comprising synovial hypertrophy, cartilage lesions, bone erosions, bone marrow changes, infrapatellar fat pad heterogeneity, effusion, tendinopathy and popliteal lymphadenopathy.

Results: The MRI examination was successfully completed in all 47 children. No scan was excluded due to poor image quality. Synovial hypertrophy was more frequent in group 1 (36.2%), but was also seen in 19.4% of the knees in group 2. Infrapatellar fat pad heterogeneity was more prevalent in group 2 (86.1%; P = 0.008). Reproducibility of the score was good (Cohen kappa, 0.49-0.96).

Conclusion: Bilateral non-contrast-enhanced open-bore knee MRI is feasible in the assessment of disease activity in unsedated children with JIA. Signs differing among children with active and inactive disease include infrapatellar fat pad heterogeneity and synovial hypertrophy.

Show MeSH
Related in: MedlinePlus