Department of Paediatric Radiology, Bicêtre hospital, University of Paris SUD, Assistance Publique-Hôpitaux de Paris (AP-HP), 94270 Le Kremlin-Bicêtre, France.
Inserm UMR 1125, Sorbonne Paris Cité, Service de rhumatologie, université Paris 13, Bobigny, hôpitaux universitaires Paris-Seine-Saint-Denis, (AP-HP), 93017 Bobigny, France; Hôpitaux universitaires Paris-Seine-Saint-Denis, (AP-HP), Service de Rhumatologie, 93017 Bobigny, France.
Joint Bone Spine. 2017 Dec;84(6):699-702. doi: 10.1016/j.jbspin.2017.07.003. Epub 2017 Jul 27.
To determine the predictors of sacroiliitis detected by magnetic resonance imaging (MRI) in children with enthesitis-related arthritis.
In this retrospective, longitudinal study, we retrieved clinical and laboratory data from the charts of patients with confirmed enthesitis related arthritis and evaluated their association with magnetic sacroiliitis detected at first MRI after disease onset. The MRI images of sacroiliac joints were read by 2 independent radiologists and validated against those from 25 age- and sex-matched subjects with known non-rheumatologic conditions.
We reviewed the clinical records of 20 patients with enthesitis-related arthritis for whom MRI images of sacroiliac joints were available. Five had bilateral MRI sacroiliitis, 3 unilateral sacroiliitis while 12 had no sacroiliitis. All MRI images of sacroiliiitis showed bone-marrow oedema but no erosions, sclerosis or sacroiliac enthesitis. Personal history of buttock pain or abnormal physical examination of sacroiliac joints predicted MRI sacroiliitis with a positive predictive value of 0.75 (95% confidence interval 0.35-0.95). In the absence of these clinical elements, MRI sacroiliitis was unlikely to be found (negative predictive value 0.83; 95% confidence interval 0.50-0.97).
In children with enthesitis-related arthritis the presence of buttock pain or of abnormal sacroiliac joint examination is a strong predictor of magnetic sacroiliitis.
确定磁共振成像（MRI）检测到的附着点关节炎相关关节炎患儿的骶髂关节炎的预测因素。
在这项回顾性、纵向研究中，我们从确诊的附着点关节炎患者的病历中检索了临床和实验室数据，并评估了它们与疾病发作后首次 MRI 检测到的磁共振骶髂关节炎之间的关系。由 2 名独立的放射科医生阅读骶髂关节的 MRI 图像，并与 25 名已知患有非风湿性疾病的年龄和性别匹配的患者的 MRI 图像进行验证。
我们回顾了 20 名附着点关节炎患者的临床记录，这些患者的骶髂关节 MRI 图像可用。5 例为双侧 MRI 骶髂关节炎，3 例为单侧骶髂关节炎，12 例无骶髂关节炎。所有 MRI 骶髂关节炎图像均显示骨髓水肿，但无侵蚀、硬化或骶髂附着点炎。臀部疼痛的个人史或骶髂关节异常体格检查预测 MRI 骶髂关节炎的阳性预测值为 0.75（95%置信区间 0.35-0.95）。在没有这些临床要素的情况下，MRI 骶髂关节炎不太可能被发现（阴性预测值 0.83；95%置信区间 0.50-0.97）。
在附着点关节炎相关关节炎的儿童中，臀部疼痛或骶髂关节异常检查是磁共振骶髂关节炎的强烈预测因素。
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