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Rheumatology International

, Volume 35, Issue 2, pp 351–357 | Cite as

Frequency of joint involvement in juvenile idiopathic arthritis during a 5-year follow-up of newly diagnosed patients: implications for MR imaging as outcome measure

  • Robert Hemke
  • Charlotte M. NusmanEmail author
  • Désirée M. F. M. van der Heijde
  • Andrea S. Doria
  • Taco W. Kuijpers
  • Mario Maas
  • Marion A. J. van Rossum
Original Article - Imaging

Abstract

To assess the sequence and type of active joints in a cohort of newly diagnosed juvenile idiopathic arthritis (JIA) patients with full access to current treatment at first visit and during a follow-up period of 5-years, in order to identify an index joint/group of joints for magnetic resonance imaging in JIA. Patient charts of all consecutive newly diagnosed JIA patients with a follow-up duration of at least 5 years were analyzed. Patients were derived from two tertiary pediatric rheumatology centers. Patient characteristics and data concerning the presence of joints with arthritis and the use of medication were recorded. Findings from 95 JIA patients [39 (41 %) oligoarticular and 56 (59 %) polyarticular] were analyzed. At first visit, distribution of active joints among patients was as follows: knee (n = 70, 74 %), ankle (n = 55, 58 %), elbow (n = 23, 24 %), wrist (n = 23, 24 %), metacarpophalangeal (MCP) (n = 20, 21 %), proximal interphalangeal (PIP) (n = 13, 14 %), hip (n = 6, 6 %), shoulder (n = 5, 5 %), and distal interphalangeal (DIP) (n = 4, 4 %) joints. After a follow-up period of 5 years, the cumulative percentage of patients with specific joint involvement changed into: knee (n = 88, 93 %), ankle (n = 79, 83 %), elbow (n = 43, 45 %), wrist (n = 38, 40 %), MCP (n = 36, 38 %), PIP (n = 29, 31 %), shoulder (n = 20, 21 %), hip (n = 17, 19 %), and DIP (n = 9, 10 %) joints. Despite changes in treatment strategies over the years, the knee remains the most commonly involved joint at onset and during follow-up in JIA, followed by the ankle, elbow, and wrist. For the evaluation of outcome with MRI, the knee appears the most appropriate joint in JIA.

Keywords

Juvenile idiopathic arthritis Joint involvement Magnetic resonance imaging Follow-up Synovitis 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Robert Hemke
    • 1
    • 2
  • Charlotte M. Nusman
    • 1
    • 2
    Email author
  • Désirée M. F. M. van der Heijde
    • 3
  • Andrea S. Doria
    • 4
  • Taco W. Kuijpers
    • 2
  • Mario Maas
    • 1
  • Marion A. J. van Rossum
    • 2
    • 5
  1. 1.Department of Radiology (G1-215), Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  2. 2.Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children’s Hospital AMCUniversity of AmsterdamAmsterdamThe Netherlands
  3. 3.Department of RheumatologyLeiden University Medical CenterLeidenThe Netherlands
  4. 4.Department of RadiologyThe Hospital for Sick ChildrenTorontoCanada
  5. 5.Department of Pediatric RheumatologyReade InstituteAmsterdamThe Netherlands

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