Graham T Brent
Division of Pediatric Rheumatology, Cincinnati Children's Hospital Medical Center, OH 45229, USA.
Curr Opin Rheumatol. 2005 Sep;17(5):574-8. doi: 10.1097/01.bor.0000169365.46196.b6.
The purpose of this review is to highlight recent developments in imaging in juvenile arthritis.
The developments in imaging in juvenile arthritis are primarily focused on evaluation of destructive changes and inflammatory changes in joints. Plain radiography can demonstrate destructive changes in juvenile arthritis. The most validated instrument for assessing destructive changes juvenile arthritis is the Poznanski index, and this index is being used more in studies to understand the natural history and clinical correlates of destructive disease. Magnetic resonance imaging has been shown to be superior to plain radiography in demonstrating destructive changes. Further work is proceeding to detect earlier, biochemical changes in articular cartilage prior to the development of thinning or erosion. Magnetic resonance imaging and ultrasound can demonstrate both inflammatory and destructive changes. Utilization of these techniques to show inflammatory changes can provide information about joints that can supplement physical examination, particularly in difficult joints to examine, such as the hips, temporomandibular joints, small joints of the feet, and tenosynovial locations. This information may help to guide therapy.
Imaging provides useful information to supplement clinical and laboratory examination in the optimal treatment of patients with juvenile arthritis.
本综述旨在强调幼年特发性关节炎影像学的最新进展。
幼年特发性关节炎影像学进展主要集中于关节破坏和炎症改变的评估。X线平片可显示幼年特发性关节炎的破坏改变。评估幼年特发性关节炎破坏改变最有效的工具是波兹南斯基指数，该指数在研究中越来越多地用于了解破坏性疾病的自然史和临床相关性。磁共振成像在显示破坏改变方面已被证明优于X线平片。目前正在进一步开展工作，以在关节软骨变薄或侵蚀出现之前更早地检测到其生化变化。磁共振成像和超声均可显示炎症和破坏改变。利用这些技术显示炎症改变可为关节提供补充体格检查的信息，尤其是在难以检查的关节，如髋关节、颞下颌关节、足部小关节和腱鞘部位。这些信息可能有助于指导治疗。
影像学可为幼年特发性关节炎患者的最佳治疗提供补充临床和实验室检查的有用信息。
