Department of Radiology, Great Ormond Street Hospital for Children, London, UK.
J Rheumatol. 2012 Mar;39(3):645-50. doi: 10.3899/jrheum.110445. Epub 2012 Feb 1.
Magnetic resonance imaging (MRI) is playing an increasingly important role in the diagnosis and followup of juvenile idiopathic arthritis (JIA). Carpal depressions are commonly observed in healthy children and in patients with JIA. The aim of our study was to further characterize these depressions in patients with JIA.
A total of 29 MRI wrist examinations were analyzed. Depressions were classified according to morphology as either tubular or focal. Features including the presence of a vessel related to the depression, evidence of synovitis, bone marrow edema, or loss of joint space on a radiograph taken on the same day were recorded for each depression.
A total of 173 depressions were identified in 145 carpal bones. Forty percent were capitate depressions. A third were focal depressions and two-thirds were tubular. About 10% of tubular depressions and 30% of focal depressions were associated with features suggesting true erosions, with the remainder likely to represent vascular channels and normal variants.
Radiologists and clinicians should undertake caution when assessing carpal depressions on MRI because the vast majority are likely to represent normal variants.
磁共振成像（MRI）在幼年特发性关节炎（JIA）的诊断和随访中发挥着越来越重要的作用。腕骨凹陷在健康儿童和 JIA 患者中很常见。本研究的目的是进一步描述 JIA 患者的这些凹陷。
分析了总共 29 例腕关节 MRI 检查。根据形态将凹陷分为管状或局灶性。记录了每个凹陷的特征，包括与凹陷相关的血管存在、滑膜炎、骨髓水肿或同一天拍摄的 X 光片上的关节间隙丢失的证据。
在 145 个腕骨中发现了 173 个凹陷。40%是头状骨凹陷。三分之一是局灶性凹陷，三分之二是管状凹陷。约 10%的管状凹陷和 30%的局灶性凹陷与提示真性侵蚀的特征相关，其余可能代表血管通道和正常变异。
放射科医生和临床医生在评估 MRI 上的腕骨凹陷时应谨慎，因为绝大多数可能代表正常变异。
