Radiographic Evaluation of Joint Changes in Juvenile Idiopathic Arthritis

Abstract

Aim:  To evaluate the spectrum of joint changes using radiography as a tool in patients with Juvenile Idiopa-thic Arthritis at presentation.

Study Design:  Observational study on prospective data.

Place and Duration of Study:  Department of Diag-nostic Radiology of The Children Hospital and The Institute of Child Health, Lahore, from October 2006 to October 2009.

Patients and Methods:  72 patients fulfilling the American college of rheumatology (ACR) criteria of JIA referred from the Rheumatology Clinic were en-rolled in the study. Radiographs of both hands PA and knees AP were obtained and interpreted by a single paediatric radiologist. Other views were obtained in individual cases when required clinically. Statistical analysis of data was done on SPSS version 16.0.

Results:  Amongst a total of 72 patients, 59 (82%) had polyarthritis, followed by oligoarthritis and systemic onset disease in 12 (17%) and 1(01%) respectively. RA factor was negative in 64 (88.9%). Late joint cha-nges were observed in 20 (27.7%) patients with erosi-ons in 8 (11.1%), boutenairre deformity in 10 (13.9%), swan neck deformity in 07 (7%) and ankylosis in 2 (2.7%) patients. Regarding late changes maximum number of patients, that is 8, were in the age group 12 to 14 years, 14 (70%) were females, 18 (90%) had polyarticular type of JIA and their duration of illness at presentation was mostly between 5 to 8 years. Further evaluating patients with erosions, age range was from 8 to 15 years, 5 (62.5%) were females, 6 (75%) had polyarticular type of JIA and their duration of illness at presentation was mostly between 3 to 5 years.

Conclusion:  Plain radiography, a readily available diagnostic modality remains the initial investigation in the evaluation of joint changes in children with JIA and its differential diagnosis. Children presenting late are at an increased risk of developing erosions which in particular can be assessed reliably in addition to monitoring of disease progression and detecting comp-lications.

Key words:  Juvenile Idiopathic Arthritis, JIA, poly-arthritis.