Division of Rheumatology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Department of Radiology, Cleveland Clinic, Cleveland, Ohio.
Curr Opin Rheumatol. 2023 Jul 1;35(4):226-234. doi: 10.1097/BOR.0000000000000942. Epub 2023 Apr 14.
Imaging is used in the diagnosis of peripheral and axial disease in juvenile spondyloarthritis (JSpA). Imaging of the joints and entheses in children and adolescents can be challenging for those unfamiliar with the appearance of the maturing skeleton. These differences are key for rheumatologists and radiologists to be aware of.
In youth, skeletal variation during maturation makes the identification of arthritis, enthesitis, and sacroiliitis difficult. A great effort has been put forward to define imaging characteristics seen in healthy children in order to more accurately identify disease. Additionally, there are novel imaging modalities on the horizon that are promising to further differentiate normal physiologic changes versus disease.
This review describes the current state of imaging, limitations, and future imaging modalities in youth, with key attention to differences in imaging interpretation of the peripheral joints, entheses, and sacroiliac joint in youth and adults.
影像学检查用于青少年脊柱关节炎（JSpA）外周和中轴疾病的诊断。对于不熟悉成熟骨骼表现的人来说，儿童和青少年关节和附着点的影像学检查具有一定挑战性。这些差异是风湿病学家和放射科医生需要注意的关键。
在青少年时期，骨骼成熟过程中的变化使得关节炎、附着点炎和骶髂关节炎的识别变得困难。为了更准确地识别疾病，人们已经付出了很大的努力来定义在健康儿童中可见的影像学特征。此外，新的影像学手段也即将出现，有望进一步区分正常的生理变化与疾病。
本文描述了目前在青少年中应用的影像学检查、局限性和未来的影像学手段，重点关注青少年与成年人外周关节、附着点和骶髂关节影像学解读的差异。
