Unit of Radiology and Laboratory of Medical Imaging Processing (LaTIM), Université de Bretagne Occidentale, Faculté de Médecine et des Sciences de la Santé, Brest, France.
Semin Arthritis Rheum. 2012 Apr;41(5):698-711. doi: 10.1016/j.semarthrit.2011.08.004. Epub 2011 Oct 28.
To assess the usefulness of imaging studies for peripheral joint assessment in children with juvenile idiopathic arthritis (JIA), based on a systematic literature review.
We used PubMed to identify relevant articles published between 2000 and 2011.
Plain radiography is still the reference imaging study for monitoring joint destruction in patients with JIA, and the results correlate well with the clinical findings. Radiographs should be obtained routinely during follow-up and in therapeutic trials. Available scoring methods have been validated in children, but no recommendations are available on the intervals between radiographic assessments. Ultrasonography and magnetic resonance imaging (MRI) can detect inflammatory changes that precede bone destruction. Ultrasonography features in JIA are still being studied. Ultrasonography can detect clinically silent synovitis, which has major implications for determining the JIA subtype. MRI is the only imaging study capable of showing bone marrow edema, which predicts joint destruction.
Although radiography remains the reference standard imaging study for assessing peripheral joint destruction in JIA, ultrasonography and MRI allow the early detection of predestructive changes, the presence of which affects treatment decisions. Much more work is needed to determine the optimal imaging protocols, the best interval between imaging evaluations during follow-up, and the therapeutic implications of imaging study findings.
通过系统文献回顾，评估影像学研究在儿童幼年特发性关节炎（JIA）外周关节评估中的作用。
我们使用 PubMed 检索了 2000 年至 2011 年间发表的相关文章。
平片仍然是监测 JIA 患者关节破坏的参考影像学研究，其结果与临床发现密切相关。在随访和治疗试验中应常规进行影像学检查。现有的评分方法已在儿童中得到验证，但在影像学评估的间隔时间方面尚无建议。超声和磁共振成像（MRI）可检测到骨破坏前的炎症变化。JIA 的超声特征仍在研究中。超声可检测到临床上无症状的滑膜炎，这对确定 JIA 亚型具有重要意义。MRI 是唯一能够显示骨髓水肿的影像学研究，骨髓水肿可预测关节破坏。
尽管平片仍然是评估 JIA 外周关节破坏的参考标准影像学研究，但超声和 MRI 可以早期发现破坏性改变，这些改变会影响治疗决策。需要做更多的工作来确定最佳的影像学检查方案、随访期间影像学评估的最佳间隔时间以及影像学研究结果的治疗意义。
