Ostrowska Monika, Michalski Emil, Gietka Piotr, Mańczak Małgorzata, Posadzy Magdalena, Sudoł-Szopińska Iwona
Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland.
Clinic of Pediatric Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland.
J Clin Med. 2022 Jan 30;11(3):760. doi: 10.3390/jcm11030760.
This retrospective case-control study aimed to evaluate whether Magnetic Resonance Imaging (MRI) enables differentiation of ankle arthritis in Juvenile Idiopathic Afrthritis JIA from ankle arthralgia of unknown aetiology in patients clinically suspected of JIA. Forty-four children, at ages 5-16, who underwent MRI of the ankle from January 2016 to March 2021 for clinically suspected active ankle arthritis in the course of JIA were included. MRI findings in both groups-patients with the final diagnosis of JIA and without final diagnosis of JIA-were compared and scored. The sum of the scores of 22 ankle lesions in an individual patient (active, destructive and developmental), so-called the MRI summarized score, was calculated and tested in terms of the most optimal diagnosis of JIA. Interobserver agreement was calculated. Inflammatory features were seen on MRI in 38 out of all the included patients (86%). The most common lesions in both groups were effusion in the tibio-talar joint (68% in JIA and 64% in the arthralgia group) and effusion in subtalar joint (64% in JIA vs. 59% in the arthralgia group). In general, more lesions were identified in the JIA group than in non-JIA. However, only tenosynovitis was significantly more common in the JIA vs. non-JIA group ( = 0.031). The MRI summarized score did not allow for discrimination between ankle arthritis in JIA from non-JIA patients; the best levels of sensitivity (32%), specificity (91%), positive predictive value PPV (78%) and negative predictive value NPV (57%) were achieved only at the cut-off point of 10.
这项回顾性病例对照研究旨在评估磁共振成像（MRI）是否能够区分青少年特发性关节炎（JIA）患者的踝关节关节炎与临床疑似JIA但病因不明的踝关节疼痛。纳入了44名年龄在5至16岁之间的儿童，这些儿童在2016年1月至2021年3月期间因临床疑似JIA病程中的活动性踝关节关节炎而接受了踝关节MRI检查。比较并对两组患者（最终诊断为JIA的患者和未最终诊断为JIA的患者）的MRI结果进行评分。计算个体患者22个踝关节病变（活动性、破坏性和发育性）的得分总和，即所谓的MRI综合评分，并根据JIA的最佳诊断进行测试。计算观察者间的一致性。在所有纳入患者中，38名（86%）在MRI上可见炎症特征。两组中最常见的病变是胫距关节积液（JIA组为68%，关节痛组为64%）和距下关节积液（JIA组为64%，关节痛组为59%）。总体而言，JIA组比非JIA组发现的病变更多。然而，只有腱鞘炎在JIA组比非JIA组更常见（P = 0.031）。MRI综合评分无法区分JIA患者与非JIA患者的踝关节关节炎；仅在临界点为10时，达到了最佳的敏感性（32%）、特异性（91%）、阳性预测值PPV（78%）和阴性预测值NPV（57%）。
