Department of Radiology, University Hospital North Norway, Tromsø, Norway.
Ann Rheum Dis. 2011 Apr;70(4):605-10. doi: 10.1136/ard.2010.135244. Epub 2010 Dec 20.
During a multicentre study on juvenile idiopathic arthritis, wide variations were observed in bone shape, signal intensity and volume of joint fluid as shown by MRI which in part appeared to be unrelated to disease activity. A study was undertaken to examine these features in a cohort of healthy children.
88 children of mean age 9.8 years (range 5-15) underwent MRI imaging (T1-weighted Spin Echo and Spectral Selection Attenuated Inversion Recovery (SPAIR)) of the left wrist. The number of bony depressions, distribution and amount of joint fluid and the presence of bone marrow changes were assessed.
Bony depressions were present in all children, increasing with age from a mean of 4.0 in children aged 4-6 years to 9.2 in those aged 12-15 years (p<0.001)). 45 of 84 children (53.6%) had a high signal on SPAIR with a corresponding low signal on T1 in at least one bone. No associations were seen between bone marrow change (present or not) and sex (p=0.827) or sports club membership (p=0.616). All children had visible joint fluid in at least one of the joints assessed. No associations were seen between the presence of joint fluid and age group, except for the radius/scaphoid and capitate-scaphoid joints and a recess lateral to the hamate.
It is important to be aware of the high prevalence of bony depressions, signal changes suggestive of bone marrow oedema and the volume of joint fluid seen in normal children. Such findings must be interpreted with care in children with suspected disease such as juvenile arthritis.
在一项关于幼年特发性关节炎的多中心研究中，磁共振成像（MRI）显示关节骨形态、信号强度和关节液体积存在广泛差异，部分似乎与疾病活动无关。本研究旨在检查一组健康儿童的这些特征。
88 名平均年龄为 9.8 岁（5-15 岁）的儿童接受了左侧腕关节 MRI 成像（T1 加权自旋回波和谱选择衰减反转恢复（SPAIR））。评估了骨凹陷的数量、关节液的分布和量以及骨髓变化的存在。
所有儿童均存在骨凹陷，随着年龄的增长而增加，4-6 岁儿童的平均凹陷数为 4.0，12-15 岁儿童的平均凹陷数为 9.2（p<0.001）。84 名儿童中有 45 名（53.6%）在至少一个骨上出现 SPAIR 高信号，T1 低信号。骨髓变化（存在或不存在）与性别（p=0.827）或体育俱乐部成员资格（p=0.616）之间未见关联。所有儿童在评估的至少一个关节中均可见关节液。除了桡骨/舟骨和头状骨/舟骨关节以及舟骨外侧隐窝外，关节液的存在与年龄组之间未见关联。
在怀疑患有幼年特发性关节炎等疾病的儿童中，必须谨慎解读正常儿童中常见的骨凹陷、提示骨髓水肿的信号变化和关节液体积。
