Pediatric Rheumatology Unit, Meyer Children University Hospital, Florence, Italy.
Department of Medical Biotechnology, University of Siena, Siena, Italy.
Pediatr Int. 2021 Nov;63(11):1282-1288. doi: 10.1111/ped.14650. Epub 2021 Oct 4.
Whole-body magnetic resonance imaging (WBMRI) is a multiregional imaging technique suitable for investigating the extent of multisystemic diseases without exposure to radiation, with a high sensitivity to bone alterations. The aim of our study was to evaluate the role of WBMRI in the workup of children with non-specific musculoskeletal features and non-indicative laboratory and instrumental data, who were suspected to have a rheumatologic disease.
We retrospectively analyzed medical records, including laboratory tests and radiological data of 34 children who had been evaluated due to non-specific musculoskeletal manifestations, for which a WBMRI was prescribed.
We included 34 children, 19 females and 15 males, mean age 10 years (range 2-16 years), with the following clinical features: diffuse arthralgia (12 children), persistent fever (2 children), persistent fever and diffuse arthralgia (20 children). Serologic inflammatory markers were increased in 29/34 patients. Twenty-five children had already received X-ray and / or ultrasound before WBMRI, with a negative / uninformative result. WBMRI was performed 3-6 weeks (median, 3.5 weeks) after the initial presentation of symptoms. In 22/34 (65%) children, WBMRI revealed some abnormalities that supported the final diagnosis. Twelve out of 34 children (35%) were be affected by chronic recurrent multifocal osteomyelitis.
WBMRI is helpful in pediatric rheumatology for the differential diagnosis of undefined inflammatory conditions. It appears to be a promising tool, especially in the detection of multifocal bone lesions. The diagnosis that mainly benefits from WBMRI in our series is chronic recurrent multifocal osteomyelitis. WBMRI can also help in excluding neoplastic diseases.
全身磁共振成像（WBMRI）是一种多区域成像技术，适合于在不暴露于辐射的情况下检查多系统疾病的范围，对骨骼改变具有较高的敏感性。我们的研究目的是评估 WBMRI 在检查具有非特异性肌肉骨骼特征和非提示性实验室及仪器数据的儿童中的作用，这些儿童疑似患有风湿病。
我们回顾性分析了 34 名因非特异性肌肉骨骼表现而接受评估并接受 WBMRI 检查的儿童的病历，包括实验室检查和影像学数据。
我们纳入了 34 名儿童，19 名女性和 15 名男性，平均年龄为 10 岁（范围 2-16 岁），具有以下临床特征：弥漫性关节炎（12 名儿童）、持续性发热（2 名儿童）、持续性发热和弥漫性关节炎（20 名儿童）。29/34 名患者的血清炎症标志物升高。25 名儿童在接受 WBMRI 之前已经接受了 X 射线和/或超声检查，结果为阴性/无提示性。WBMRI 在症状初始出现后 3-6 周（中位数 3.5 周）进行。在 22/34 名（65%）儿童中，WBMRI 显示出一些支持最终诊断的异常。34 名儿童中有 12 名（35%）患有慢性复发性多灶性骨髓炎。
WBMRI 有助于儿科风湿病学对未明原因的炎症性疾病进行鉴别诊断。它似乎是一种很有前途的工具，特别是在检测多灶性骨病变方面。在我们的系列中，主要受益于 WBMRI 的诊断是慢性复发性多灶性骨髓炎。WBMRI 还可以帮助排除肿瘤性疾病。
