Drs. Giancane and Pederzoli contributed equally to this work
Frequency of radiographic damage and progression in individual joints in children with juvenile idiopathic arthritis
Copyright © 2013 American College of Rheumatology
- Accepted manuscript online: 27 AUG 2013 03:26PM EST
- Manuscript Accepted: 9 AUG 2013
- Manuscript Revised: 31 JUL 2013
- Manuscript Received: 30 MAR 2013
- Italian Ministry of Health (“Ricerca corrente, 5 per mille”)
- Cited By
- Juvenile idiopathic arthritis;
- radiographic damage;
- radiographic progression;
- conventional radiology
Objective. To evaluate the presence and progression of radiographic joint damage, as assessed with the adapted Sharp-van der Heijde (aSH) score, in individual joints in the hand and wrist in patients with juvenile idiopathic arthritis (JIA), and to compare progression of damage among different JIA categories.
Methods. A total of 372 radiographs of both wrists and hands obtained at first observation and at last follow-up visit (after 1 to 10 years) in 186 children with polyarticular-course JIA were evaluated. All radiographs were scored using the aSH scoring system by 2 independent readers. Radiographic assessment included evaluation of joint space narrowing (JSN) and erosions on baseline and last follow-up radiographs and of progression of radiographic changes from baseline to last follow-up radiographs.
Results. Both JSN and erosions occurred in all aSH areas. Overall, radiographic damage and progression were more common in the wrist and less common in metacarpophalangeal joints. The hamate and capitate areas appeared particularly vulnerable to cartilage loss. Erosions were identified most frequently in the hamate and capitate bones as well as in the 2nd and 3rd metacarpal bases. Patients with extended oligoarthritis were distinctly less susceptible to JSN in hand joints, whereas patients with polyarthritis showed a greater tendency to developing erosions in hand joints.
Conclusion. Radiographic joint damage and progression in our patients with JIA were seen most commonly in the wrist and less commonly in MCP joints. The frequency and localization of structural abnormalities differed markedly across disease categories. © 2013 American College of Rheumatology.