Harel L, Wagner-Weiner L, Poznanski A K, Spencer C H, Ekwo E, Magilavy D B
Section of Pediatric Rheumatology, La Rabida Children's Hospital, University of Chicago, Illinois.
Arthritis Rheum. 1993 Oct;36(10):1370-4. doi: 10.1002/art.1780361007.
To assess the effects of methotrexate (MTX) therapy on radiologic progression in juvenile rheumatoid arthritis (JRA).
We evaluated serial wrist radiographs for carpal length in 23 JRA patients with bilateral wrist involvement, before and during MTX treatment. These carpal length measurements were compared with established norms for carpal length in a healthy pediatric population.
Both clinical responders to MTX (17 of 23 patients) and nonresponders (6 of 23) had decreasing carpal length prior to initiation of the treatment. Eleven of the 17 clinical responders had improved carpal length after a mean of 2.5 years of MTX treatment. All 6 clinical nonresponders had progressive loss of carpal length.
MTX treatment resulted in radiologic improvement, as measured by carpal length, in the majority of children with JRA who had a clinical response to MTX.
评估甲氨蝶呤（MTX）治疗对青少年类风湿性关节炎（JRA）放射学进展的影响。
我们对23例双侧腕关节受累的JRA患者在MTX治疗前及治疗期间的系列腕部X线片进行评估，测量腕骨长度。将这些腕骨长度测量值与健康儿童群体既定的腕骨长度标准进行比较。
MTX治疗的临床反应者（23例患者中的17例）和无反应者（23例中的6例）在开始治疗前腕骨长度均下降。17例临床反应者中有11例在平均接受2.5年MTX治疗后腕骨长度有所改善。所有6例临床无反应者腕骨长度均呈进行性丢失。
对于大多数对MTX有临床反应的JRA儿童，以腕骨长度衡量，MTX治疗可带来放射学改善。
