THE EFFECTIVENESS OF MR
IMAGING FOR DIAGNOSIS IN EARLY-STAGE JUVENILE RHEUMATOID ARTHRITIS. Kawai H, Kondo Y. Nagano
Children’s Hospital, Toyoshina, Japan. Objective: We studied MR imaging
to evaluate the early changes of the inflamed joints in patients with
juvenile rheumatoid arthritis (JRA), because the diagnosis of JRA by
clinical assessment is sometimes difficult in early stage, especially in
younger children. Methods: Seven JRA patients (age
range 1-16 years) in early stage (within 6 months after onset) were
studied. Four patients were polyarticular type and three were
pauciarticular type. MR images of nine joints (hand, shoulder, knee, ankle)
were obtained on T1 weighted images before and after gadolinium DTPA, T2
weighted images, and gadolinium enhanced fat-suppressed T1 weighted images. Results: Synovial membrane
inflammation and hypertrophy were detected in all nine joints after
contrast enhancement. Joint effusions were detected in seven joints of six
patients. Early cartilage erosions were demonstrated in four joints. Pannus
formation was found in one patient. Bone marrow edema of wrists was
identified in a patient who suffered from wrist contracture soon after
onset. This finding suggests the progressive bone and joint destruction. Conclusion: MR imaging is an
effective methods for detecting early changes of joints in JRA patients,
such as synovial hypertrophy, joint effusion, cartilage erosion, pannus
formation and bone marrow edema. MR imaging improve diagnostic accuracy,
predict prognosis and monitor therapy in patients with JRA.
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