Pamela F Weiss1,2, Nancy A Chauvin3, Johannes Roth4,5. 1. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. WEISSPA@email.chop.edu. 2. Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA. WEISSPA@email.chop.edu. 3. Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA. 4. University of Ottawa, Ottawa, ON, Canada. 5. Division of Pediatric Rheumatology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
Abstract
PURPOSE OF REVIEW: This review aims to provide an update on the use of imaging in the assessment of juvenile spondyloarthritis (JSpA) disease manifestations. RECENT FINDINGS: Recent studies have demonstrated superior reliability and specificity of MRI for assessment of sacroiliac joint inflammation compared with radiography. The use of gadolinium contrast may not add incremental value to the assessment of inflammatory sacroiliitis. Sacroiliitis is common at diagnosis of spondyloarthritis. Inflammatory changes of the lumbar spine are not uncommon, and changes over time in the sacroiliac and apophyseal joints may not be concordant. Ultrasonography (US) in turn has been recognized as an excellent imaging technique to visualize the peripheral manifestations of JSpA. US does not only add important information to the clinical assessment but also helps to understand the complexity of the enthesis. Recognition of specific aspects in children is important though. The standardization of image acquisition as well as the establishment of the evidence base are underway. MRI and ultrasonography are recognized as increasingly important tools in the diagnosis and management of juvenile spondyloarthritis.
PURPOSE OF REVIEW: This review aims to provide an update on the use of imaging in the assessment of juvenile spondyloarthritis (JSpA) disease manifestations. RECENT FINDINGS: Recent studies have demonstrated superior reliability and specificity of MRI for assessment of sacroiliac joint inflammation compared with radiography. The use of gadolinium contrast may not add incremental value to the assessment of inflammatory sacroiliitis. Sacroiliitis is common at diagnosis of spondyloarthritis. Inflammatory changes of the lumbar spine are not uncommon, and changes over time in the sacroiliac and apophyseal joints may not be concordant. Ultrasonography (US) in turn has been recognized as an excellent imaging technique to visualize the peripheral manifestations of JSpA. US does not only add important information to the clinical assessment but also helps to understand the complexity of the enthesis. Recognition of specific aspects in children is important though. The standardization of image acquisition as well as the establishment of the evidence base are underway. MRI and ultrasonography are recognized as increasingly important tools in the diagnosis and management of juvenile spondyloarthritis.
Entities:
Keywords:
Enthesitis-related arthritis; Juvenile arthritis; Magnetic resonance imaging; Spondyloarthritis; Ultrasound
Authors: M Bollow; J Braun; T Biedermann; S Mutze; S Paris; C Schauer-Petrowskaja; K Minden; S A Schmitz; M Schöntube; B Hamm Journal: Skeletal Radiol Date: 1998-11 Impact factor: 2.199