Damasio Maria Beatrice, de Horatio L Tanturri, Boavida P, Lambot-Juhan K, Rosendahl K, Tomà P, Muller Ls Ording
Department of Radiology, Istituto Giannina Gaslini, Genoa, Italy.
Acta Radiol. 2013 Nov;54(9):1015-23. doi: 10.1177/0284185113493777. Epub 2013 Jul 19.
Juvenile idiopathic arthritis (JIA) is a heterogeneous condition encompassing all forms of chronic arthritis of unknown origin and with onset before 16 years of age. During the last decade new, potent therapeutic agents have become available, underscoring the need for accurate monitoring of therapeutic response on both disease activity and structural damage to the joint. However, so far, treatment efficacy is based on clinical ground only, although clinical parameters are poor markers for disease activity and progression of structural damage. Not so for rheumatoid arthritis patients where the inclusion of radiographic assessment has been required by FDA to test the disease-modifying potential of new anti-rheumatic drugs. In imaging of children with JIA there has been a shift from traditional radiography towards newer techniques such as ultrasound and MRI, however without proper evaluation of their accuracy and validity. We here summarize present knowledge and discuss future challenges in imaging children with JIA.
幼年特发性关节炎（JIA）是一种异质性疾病，涵盖所有病因不明且发病于16岁之前的慢性关节炎形式。在过去十年中，新型强效治疗药物已可供使用，这凸显了准确监测疾病活动度和关节结构损伤治疗反应的必要性。然而，到目前为止，治疗效果仅基于临床依据，尽管临床参数对于疾病活动度和结构损伤进展而言是较差的指标。类风湿关节炎患者的情况则不同，美国食品药品监督管理局（FDA）要求纳入影像学评估以测试新型抗风湿药物的病情改善潜力。在JIA患儿的影像学检查中，已从传统放射学转向了超声和磁共振成像等更新的技术，然而却没有对这些技术的准确性和有效性进行适当评估。我们在此总结了现有知识，并讨论了JIA患儿影像学检查未来面临的挑战。
