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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

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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.

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Authors and Affiliations

  1. Department of Radiology (G1-215), Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Robert Hemke, Charlotte M. Nusman & Mario Maas

  2. Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children’s Hospital AMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands

    Robert Hemke, Charlotte M. Nusman, Taco W. Kuijpers & Marion A. J. van Rossum

  3. Department of Rheumatology, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands

    Désirée M. F. M. van der Heijde

  4. Department of Radiology, The Hospital for Sick Children, 555 University Avenue, Toronto, Canada

    Andrea S. Doria

  5. Department of Pediatric Rheumatology, Reade Institute, Dr. Jan van Breemenstraat 2, Amsterdam, The Netherlands

    Marion A. J. van Rossum

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  1. Robert Hemke
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  2. Charlotte M. Nusman
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Correspondence to Charlotte M. Nusman.

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Hemke, R., Nusman, C.M., van der Heijde, D.M.F.M. et al. 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. Rheumatol Int 35, 351–357 (2015). https://doi.org/10.1007/s00296-014-3108-x

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  • DOI: https://doi.org/10.1007/s00296-014-3108-x

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