MRI of the wrist in juvenile idiopathic arthritis: erosions or normal variants? A prospective case-control study
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ORIGINAL ARTICLE
MRI of the wrist in juvenile idiopathic arthritis: erosions or normal variants? A prospective case-control study Lil-Sofie Ording Muller & Peter Boavida & Derk Avenarius & Beatrice Damasio & Odd Petter Eldevik & Clara Malattia & Karen Lambot-Juhan & Laura Tanturri & Catherine M. Owens & Karen Rosendahl Received: 20 June 2012 / Revised: 9 November 2012 / Accepted: 12 November 2012 / Published online: 3 January 2013 # Springer-Verlag Berlin Heidelberg 2012
Abstract Background Bony depressions at the wrist resembling erosions are frequently seen on MRI in healthy children. The accuracy of MRI in detecting early bony destruction is therefore questionable. We compared findings on MRI of the wrist in healthy children and those with juvenile idiopathic arthritis (JIA) to investigate markers for true disease. Materials and methods We compared the number and localisation of bony depressions at the wrist in 85 healthy children and 68 children with JIA, ages 5–15 years. The size of the wrist was assessed from a radiograph of the wrist performed on the same day as the MRI. Results No significant difference in the number of bony depressions in the carpal bones was seen between healthy children and children with JIA at any age. Depressions are found in similar locations in the two groups, except for a few sites, where bony depressions were seen exclusively in L.-S. Ording Muller : D. Avenarius : O. P. Eldevik Department of Radiology, University Hospital North Norway, Tromsø, Norway
the JIA group, particularly at the CMC joints. The wrist was significantly smaller in children with JIA (P < 0.001). Conclusions Using adult scoring systems and standard MR sequences in the assessment of bone destruction in children may lead to overstaging or understaging of disease. At present, standard MRI sequences cannot easily be used for assessment of early signs of erosions in children. Keywords Wrist . MRI . Children . Normal . Juvenile idiopathic arthritis . JIA . Erosions
Introduction Juvenile idiopathic arthritis is a heterogeneous condition including all forms of chronic arthritis of unknown origin L. Tanturri Department of Radiology, Ospedale Pediatrico Bambino Gesu, Rome, Italy
L.-S. Ording Muller : C. M. Owens : K. Rosendahl Department of Radiology, Great Ormond Street Hospital for Children, London, UK
C. M. Owens : K. Rosendahl Institute of Child Health, UCL, London, UK
P. Boavida Department of Radiology, Homerton University Hospital, London, UK
K. Rosendahl Department of Radiology, Haukeland University Hospital, Bergen, Norway
B. Damasio Department of Radiology, Ospedale Pediatrico Gaslini, Genoa, Italy C. Malattia Department of Rhematology, Ospedale Pediatrico Gaslini, Genoa, Italy K. Lambot-Juhan Department of Radiology, Hopital Necker Enfants Malades, Paris, France
K. Rosendahl Department of Surgical Sciences, University of Bergen, Bergen, Norway
L.-S. Ording Muller (*) Dalsveien 40H, 0775 Oslo, Norway e-mail: [email protected]
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and with onset before 16 years of age. It is characterized by chro
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