Sudoł-Szopińska Iwona, Jans Lennart, Jurik Anne Grethe, Hemke Robert, Eshed Iris, Boutry Nathalie
Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation and Department of Medical Imaging, Medical University of Warsaw, Warsaw, Poland.
Department of Radiology, Ghent University Hospital, Gent, Belgium.
Semin Musculoskelet Radiol. 2018 Apr;22(2):147-165. doi: 10.1055/s-0038-1639468. Epub 2018 Apr 19.
We discuss the imaging of several juvenile inflammatory arthropathies including juvenile idiopathic arthritis, juvenile systemic lupus erythematosus, juvenile scleroderma, juvenile dermatomyositis, and chronic recurrent multifocal osteomyelitis. Juvenile idiopathic arthritis is the most common autoimmune chronic systemic disease of connective tissue in children. The remaining systemic juvenile connective tissue diseases are rare. However, they require early diagnosis and initiation of treatment to prevent injury, not only to the musculoskeletal system but also to the internal organs, and even death. Imaging of juvenile inflammatory arthropathies has relied for years on radiography. Recent advances in disease-modifying drugs have led to a greater emphasis on the detection of early inflammation not evident on plain radiography. Ultrasound examination allows for the early recognition of the disease process in the soft tissues. Magnetic resonance imaging detects early inflammatory changes involving the soft tissues, the subcortical bone of peripheral joints, the spine, and entheses.
我们讨论了几种青少年炎性关节病的影像学表现，包括青少年特发性关节炎、青少年系统性红斑狼疮、青少年硬皮病、青少年皮肌炎和慢性复发性多灶性骨髓炎。青少年特发性关节炎是儿童最常见的自身免疫性慢性系统性结缔组织疾病。其余的青少年系统性结缔组织疾病较为罕见。然而，它们需要早期诊断并开始治疗，以防止不仅对肌肉骨骼系统，而且对内脏器官造成损伤，甚至危及生命。多年来，青少年炎性关节病的影像学检查一直依赖于X线摄影。疾病改善药物的最新进展使得更加强调对X线平片上不明显的早期炎症的检测。超声检查能够早期识别软组织中的疾病进程。磁共振成像可检测涉及软组织、外周关节的皮质下骨、脊柱和附着点的早期炎症变化。
