Ostrowska Monika, Gietka Piotr, Mańczak Małgorzata, Michalski Emil, Sudoł-Szopińska Iwona
Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland.
Clinic of Paediatric Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland.
J Clin Med. 2021 Nov 11;10(22):5252. doi: 10.3390/jcm10225252.
The aim of this study was to evaluate if magnetic resonance imaging allows hip arthritis in JIA to be differentiated from hip arthralgia of unknown etiology in juveniles clinically suspected for hip arthritis. This was a retrospective observational study which included 97 children with clinically suspected hip arthritis. Each hip was assessed and scored in MRI for signs of active and destructive inflammatory lesions and developmental lesions. MRI findings between JIA-confirmed patients and without final diagnosis of JIA were compared and the MRI summarized score was calculated, as the sum of scorings of all 24 hip lesions in an individual patient (i.a., effusion, synovitis, bone marrow edema, enthesitis). MRI showed at least one lesion in the majority of patients (95 patients; 98%). Effusion was the most common feature, followed by bone marrow oedema and synovitis. All lesions were more common in patients with a final diagnosis of JIA, especially synovitis and enthesitis ( = 0.037 and = 0.047). The MRI summarized score was significantly higher in the JIA group than the non-JIA group: 3 (2-5) vs. 2 (2-2), respectively, = 0.002. Using a cut-off score of 6, the MRI summarized score showed 25% sensitivity and 100% specificity indicating a good ability in discriminating hip arthritis during JIA from non-JIA patients. MRI allows hip arthritis in JIA to be differentiated from hip arthralgia of unknown etiology with good specificity, thus, may be helpful in confirming the diagnosis of JIA.
本研究的目的是评估磁共振成像是否能将幼年特发性关节炎（JIA）中的髋关节关节炎与临床疑似髋关节关节炎的青少年病因不明的髋关节疼痛区分开来。这是一项回顾性观察研究，纳入了97例临床疑似髋关节关节炎的儿童。对每个髋关节进行磁共振成像评估并评分，以确定是否存在活动性和破坏性炎性病变以及发育性病变。比较确诊为JIA的患者和未最终诊断为JIA的患者的磁共振成像结果，并计算磁共振成像总结评分，即个体患者所有24个髋关节病变评分的总和（如积液、滑膜炎、骨髓水肿、附着点炎）。大多数患者（95例；98%）的磁共振成像显示至少有一个病变。积液是最常见的特征，其次是骨髓水肿和滑膜炎。所有病变在最终诊断为JIA的患者中更为常见，尤其是滑膜炎和附着点炎（P = 0.037和P = 0.047）。JIA组的磁共振成像总结评分显著高于非JIA组：分别为3（2 - 5）和2（2 - 2），P = 0.002。使用截断评分为6时，磁共振成像总结评分显示出25%的敏感性和100%的特异性，表明在区分JIA期间的髋关节关节炎与非JIA患者方面具有良好的能力。磁共振成像能够以良好的特异性将JIA中的髋关节关节炎与病因不明的髋关节疼痛区分开来，因此，可能有助于确诊JIA。
