Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose
Chronic arthritis occurs relatively frequent in childhood. Patients with polyarticular disease might have a destructive disease course and thus a worse outcome. In adult rheumatology MRI is known to detect erosions in early stages. In children little is known about changes in bone structure during the course of JIA and thus erosions detected by MRI are discussed controversially. (1-3)
To test, whether MRI erosions in patients with chronic arthritis are true erosions as detected by conventional computed tomography (CT).
Methods
Six children (all female) with a median age of 14 years, 4 with polyarthritis, 1 – psoriatic arthritis and 1 with systemic sclerosis were identified as having both MRI and CT of the same wrist during retrospective chart review. The median disease duration was 4 years. All patients with treated with sq methotrexate and NSAR.
A descriptive statistical approach was chosen due to the relatively low number of patients.
Results
Overall 55 surfaces were evaluated both in MRI and CT; in MRI 9 erosions were detected by MRI and 19 by CT. In MRI erosions were localized in the Os capitatum and hamatum, whereas in CT erosions were found in all carpal bones despite the scaphoid as well as in the 2nd through 4th proximal metacarpal bone. Of the 9 erosions detected in MRI, 5 were confirmed as being true bone erosions in CT and 4 MRI erosions were detected as vessel channels in CT. Widths in MRI varied from 1.50-3.50mm, and depths from 2.00-4.00mm. In CT widths ranged from 0.57-3.07mm, and depths from 0.95-3.24mm. Due to contrast agent artifacts, no physiological vessel channels could be detected, whereas in CT 254 vessel channels were found. Visualization of os pisiforme was difficult in MRI because of soft tissue and signal of immature bone.
Conclusion
Erosions in the bone of patients with chronic arthritis vizualised by MRI relate to pathological cortical defects as detected by conventional CT. Our findings suggest that these pathological CT-alterations represent either premature or manifest bone erosions identical to those in adult bone. Given the irradiation dose of conventional CT, future imaging studies are needed in order to evaluate the significance of novel CT-techniques with lower irradiation load such as HR-pQCT for use in juvenile chronic arthritis.
Disclosure:
S. Finzel,
None;
G. A. Schett,
Abbott, Celgene Corporation, Roche, and UCB,
2,
Abbott, Celgene Corporation, Roche, and UCB,
5;
N. Tzaribachev,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/erosions-detected-by-magnet-resonance-imaging-in-patients-with-juvenile-idiopathic-arthritis-jia-are-true-erosions-as-visualized-by-computed-tomography/