Abstract
Abstract
Introduction
Bone marrow edema (BME) is one of the main imaging characteristics of juvenile idiopathic arthritis (JIA) in children and rheumatoid arthritis (RA) in adult. Previous studies have shown that BME occurred in approximately 64% of adults with RA and was a key predictor of poor prognosis. But BME with JIA has not been of great concern. Therefore, we evaluated the prevalence, characteristics, and prognosis of knee joint BME in children with JIA.
Methods
In this retrospective study, we included children with JIA and knee joint involvement from January 2017 to December 2019. BME was evaluated according to the Juvenile Arthritis MRI Scoring system. Clinical characteristics were compared between the BME group and the non-BME group. The characteristics and prognosis of the BME were observed.
Results
A total of 128 children with 136 knee joint MRI data were identified, with 37 knee joints (27.2%) having BME. BME has positive correlation with synovial hypertrophy (Rs = 0.562, p = 0.019). There were significant differences in age (p = 0.010) and disease duration (p = 0.013) between the BME and non-BME groups. BME was found to be more common in older children and the patients with long duration of disease. Locations with BME were the lateral tibial plateau (17/37, 45.9%), the lateral weight-bearing femur (16/37, 43.2%), the medial tibial plateau and the medial femoral condyle (both with 15/37, 40.5%), and the medial weight-bearing femur (12/37, 32.4%). The lateral femoral condyle and both the lateral and medial sides of the patella were rarely involved. Of the 15 BME joints with the MRI follow-up data (interval 6.5 ± 3.0 months), the lesions disappeared or improved within 12 months after the treatments in 13 (86.7%) joints.
Conclusions
The prevalence of knee BME in JIA was 27.2%. There was positive correlation between BME and synovial hypertrophy. Older children and children with long disease duration had a higher risk for BME, which was commonly a late presentation and more likely involved the weight-bearing surfaces of the joint. The overall prognosis was satisfactory after the standard treatments.
Key Points• To the best of our knowledge, this paper is the first one to investigate the MRI manifestation in JIA focus on knee BME sign.
Publisher
Springer Science and Business Media LLC
Subject
General Medicine,Rheumatology
Reference20 articles.
1. Magni-Manzoni S, Scire CA, Ravelli A, Klersy C, Rossi S, Muratore V et al (2013) Ultrasound-detected synovial abnormalities are frequent in clinically inactive juvenile idiopathic arthritis, but do not predict a flare of synovitis. Ann Rheum Dis 72(2):223–228. https://doi.org/10.1136/annrheumdis-2011-201264
2. Hemke R, Nusman CM, van der Heijde DMF et al (2015) Frequency of joint involvement in juvenile idiopathic arthritis during a 5-year follow-up of newly diagnosed patients: implications for MR imaging as outcome measure. Rheumatol Int 35(2):351–357. https://doi.org/10.1007/s00296-014-3108-x
3. Hemke R, Tzaribachev N, Barendregt AM et al (2018) Imaging of the knee in juvenile idiopathic arthritis. Pediatr Radiol 48(6):818–827. https://doi.org/10.1007/s00247-017-4015-6
4. Østergaard M, Peterfy C, Conaghan P et al (2003) OMERACT rheumatoid arthritis magnetic resonance imaging studies. Core set of MRI acquisitions, joint pathology definitions, and the OMERACT RA-MRI scoring system. J Rheumatol 30(6):1385–1386
5. Hemke R, van Veenendaal M, van den Berg JM et al (2014) One-year followup study on clinical findings and changes in magnetic resonance imaging-based disease activity scores in juvenile idiopathic arthritis. J Rheumatol 41(1):119–127. https://doi.org/10.3899/jrheum.130235
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