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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