a Clinica Pediatrica e Reumatologia , Istituto Giannina Gaslini , Genova , Italy.
b Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili , Università degli studi di Genova , Italy.
Expert Rev Clin Immunol. 2018 Aug;14(8):681-694. doi: 10.1080/1744666X.2018.1496019. Epub 2018 Jul 20.
The prognosis of juvenile idiopathic arthritis (JIA) has changed dramatically due to the availability of novel drugs. Prompt diagnosis and treatment are essential to prevent permanent joint damage. As a result, methods to improve JIA diagnosis and prognosis are of high priority to tailor treatment strategies and maximize their efficacy. Musculoskeletal ultrasound and magnetic resonance imaging are more sensitive than clinical examination and radiography in the detection of joint involvement and might play a substantial role to optimize the management of JIA. Areas covered: This review compiles an inventory of potential uses of imaging studies in the modern practice of pediatric rheumatology, together with a critical analysis of the major challenges that are still to be addressed. Imaging appearance of normal growth-related changes of the musculoskeletal system will be discussed. Expert commentary: Knowledge of the evolving patterns of skeletal maturity is paramount to define pathological findings and avoid misinterpretations. Establishing a novel radiological algorithm for a rational use of imaging in JIA is of high priority to allow a speedier integration of imaging into the clinical workflow and decision-making process.
由于新型药物的出现，幼年特发性关节炎（JIA）的预后发生了巨大变化。及时诊断和治疗对于预防永久性关节损伤至关重要。因此，提高 JIA 诊断和预后的方法对于制定治疗策略和最大限度提高其疗效具有重要意义。肌肉骨骼超声和磁共振成像在检测关节受累方面比临床检查和 X 射线更敏感，可能在优化 JIA 管理方面发挥重要作用。
本综述汇集了影像学研究在儿科风湿病学现代实践中的潜在用途，并对仍需解决的主要挑战进行了批判性分析。还将讨论肌肉骨骼系统正常生长相关变化的影像学表现。
了解骨骼成熟度的变化模式对于确定病理性发现和避免误解至关重要。为合理使用 JIA 中的影像学建立新的放射学算法对于将影像学更快地纳入临床工作流程和决策过程中具有重要意义。
