Department of Radiology, University Children's Hospital Ljubljana, University Medical Center Ljubljana, Bohoričeva 20, 1000, Ljubljana, Slovenia.
Department of Radiology, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
Pediatr Radiol. 2024 Apr;54(4):481-489. doi: 10.1007/s00247-023-05742-2. Epub 2023 Aug 29.
The current role of conventional radiography in the diagnosis, monitoring and prognosis of juvenile idiopathic arthritis (JIA) is reviewed, as its role has changed with the increasing use of ultrasound and magnetic resonance imaging, as well as with the introduction of biological drugs. Conventional radiography does not play an important role in the diagnosis of JIA, as this is based on history, clinical examination and laboratory findings. The main role of conventional radiography is in the detection and monitoring of growth disorders and chronic structural and morphological changes of the affected joints and bones, in addition to helping with the differential diagnosis of conditions that mimic JIA. Radiographic changes of the joints depend on the age of the child, the type and duration of arthritis and the specific joints affected. There are no standard protocols for arthritis monitoring and most indications for imaging are based on individual case-by-case decisions. The development of degenerative joint changes is considered a poor predictive factor, but there are no clear studies that more precisely define the predictive value of radiographic changes. Conventional radiography remains an important imaging modality in narrowing the differential diagnosis and in evaluating growth disorders and the developing destructive joint changes.
本文回顾了传统放射学在幼年特发性关节炎（JIA）的诊断、监测和预后中的作用，因为随着超声和磁共振成像的广泛应用以及生物药物的引入，其作用发生了变化。传统放射学在 JIA 的诊断中并没有重要作用，因为它是基于病史、临床检查和实验室发现的。传统放射学的主要作用是检测和监测生长障碍以及受累关节和骨骼的慢性结构和形态变化，此外还可帮助鉴别模仿 JIA 的疾病。关节的放射学变化取决于儿童的年龄、关节炎的类型和持续时间以及特定受累的关节。关节炎监测没有标准方案，大多数影像学检查的适应证都是基于个别病例的决策。退行性关节变化的发展被认为是一个预后不良的因素，但没有明确的研究更精确地定义放射学变化的预测价值。传统放射学仍然是一种重要的影像学手段，可以缩小鉴别诊断的范围，并评估生长障碍和正在发展的破坏性关节变化。
