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Pediatric Imaging |
1 From the Departments of Radiology (V.M.G.M., B.J.D., T.L., N.D.J., A.E.O.) and Rheumatology (T.B.G., M.H.P.), Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039; and the Department of Radiology, Milton Hershey Medical Center, Hershey, Pa (J.S.B.). Received February 8, 2000; revision requested March 27; final revision received February 23, 2001; accepted February 26. Supported by National Institutes of Health grant 1-P60-AR44059-01. Address correspondence to V.M.G.M. (e-mail: gylys.morin@chmcc.org).
PURPOSE: To determine the magnetic resonance (MR) imaging findings in the knee in early juvenile rheumatoid arthritis.
MATERIALS AND METHODS: MR imaging (1.5 T) was performed in the more symptomatic knee in 30 children with juvenile rheumatoid arthritis with a symptom duration 1 year or less. Conventional, fast spin-echo, three-dimensional gradient-echo, and gadolinium-enhanced T1-weighted images were assessed. Two radiologists independently read the images, and a third resolved disagreements. These images were compared with knee radiographs in 27 children.
RESULTS: Mean maximal synovial thickness was 4.8 mm ± 2.4 (SD). Mean synovial volume was 15.4 mL ± 10.8. Suprapatellar joint effusions were seen in 26 (87%) of 30 knees, meniscal hypoplasia in 11 (37%) of 30 knees, and abnormal epiphyseal marrow in eight (27%) of 30 knees. Three knees had articular cartilage contour irregularity, fissures, and/or thinning. One knee had a bone erosion. Knee radiographs showed suprapatellar fullness in 78% of the knees, joint space narrowing in one knee, and no bone abnormalities.
CONCLUSION: Synovial hypertrophy and joint effusions are the most frequent MR imaging findings of knees in early juvenile rheumatoid arthritis. Early in the disease, radiographically occult cartilage and bone erosions are uncommonly seen at MR imaging. The potential relationship of synovitis to cartilage abnormalities deserves further study.
Index terms: Arthritis, in infants and children, 452.713 • Arthritis, rheumatoid, 452.713 • Knee, arthritis, 452.713 • Knee, MR, 452.121411, 452.121412, 453.121415, 452.12143
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