Sudhakar Murugan, Deswal Shivani, Sachdev Namrita, Pal Somdipa, Pal Yadav Tribhuvan
Department of Pediatrics, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India.
Department of Radiodiagnosis, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India.
Arch Rheumatol. 2022 Sep 20;37(4):547-558. doi: 10.46497/ArchRheumatol.2022.9304. eCollection 2022 Dec.
We aimed to evaluate shoulder joint by magnetic resonance imaging (MRI) using the Juvenile Arthritis Magnetic Resonance Imaging Scoring (JAMRIS) system in children with juvenile idiopathic arthritis (JIA) and to compare clinical, laboratory parameters and disease activity scores with MRI parameters.
A total of 32 shoulder joints of 20 patients (16 males, 4 females; mean age: 8.9±3.5 years; range, 2.5 to 14 years) with a known diagnosis of JIA and a clinical suspicion of shoulder joint involvement and underwent MRI were included. Reliability was determined by inter- and intra-observer correlation coefficients. Correlation of the clinical and laboratory parameters with JAMRIS scores was done using the non-parametric tests. Sensitivity of clinical examination to detect shoulder joint arthritis was also determined.
Of the 32 joints, 27 joints in 17 patients showed MRI changes. Seven joints in five patients fulfilled the definition of clinical arthritis, all revealed MRI changes. In 25 joints without clinical arthritis, early and late MRI changes were seen in 19 (67%) and 12 (48%) joints, respectively. The inter- and intra-observer correlation coefficients for JAMRIS system were excellent. No correlation was found between MRI parameters, clinical, laboratory, and disease activity scores. The sensitivity of clinical examination to detect shoulder joint arthritis was 25.9%.
The JAMRIS system is reliable and reproducible to determine shoulder joint inflammation in JIA. Detection of shoulder joint arthritis by clinical examination has a poor sensitivity.
我们旨在使用青少年特发性关节炎磁共振成像评分（JAMRIS）系统，通过磁共振成像（MRI）评估青少年特发性关节炎（JIA）患儿的肩关节，并比较临床、实验室参数及疾病活动评分与MRI参数。
纳入20例已知诊断为JIA且临床怀疑肩关节受累并接受MRI检查的患者（16例男性，4例女性；平均年龄：8.9±3.5岁；范围2.5至14岁）的32个肩关节。通过观察者间和观察者内相关系数确定可靠性。使用非参数检验分析临床和实验室参数与JAMRIS评分的相关性。还确定了临床检查检测肩关节关节炎的敏感性。
32个关节中，17例患者的27个关节显示MRI改变。5例患者的7个关节符合临床关节炎的定义，均显示MRI改变。在25个无临床关节炎的关节中，分别有19个（67%）和12个（48%）关节出现早期和晚期MRI改变。JAMRIS系统的观察者间和观察者内相关系数极佳。未发现MRI参数、临床、实验室及疾病活动评分之间存在相关性。临床检查检测肩关节关节炎的敏感性为25.9%。
JAMRIS系统在确定JIA患者肩关节炎症方面可靠且可重复。临床检查检测肩关节关节炎的敏感性较差。
