TY - JOUR
T1 - Exploring contrast-enhanced MRI findings of the clinically non-inflamed symptomatic pediatric wrist
AU - Verkuil, Floris
AU - van Gulik, E. Charlotte
AU - Nusman, Charlotte M.
AU - Barendregt, Anouk M.
AU - Nassar-Sheikh Rashid, Amara
AU - Schonenberg-Meinema, Dieneke
AU - Dolman, Koert M.
AU - Maas, Mario
AU - Kuijpers, Taco W.
AU - van den Berg, J. Merlijn
AU - Hemke, Robert
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Background: Knowledge of the synovial and tenosynovial appearance of the clinically non-arthritic symptomatic juvenile wrist using contrast-enhanced magnetic resonance imaging (MRI) is sparse. Objectives: To analyze contrast-enhanced MRI findings of the clinically non-inflamed symptomatic pediatric wrist, focusing on the enhancing synovial and tenosynovial membrane. To evaluate the coexistent presence of (teno)synovial enhancement, joint fluid, bony depressions and medullary changes suggestive of bone marrow edema. Materials and methods: We included 20 children (15 girls; age range: 7.5–17.6 years) who underwent contrast-enhanced MRI of the wrist, based on initial clinical indication, and eventually turned out to be unaffected by arthritic or orthopedic disorders. Various imaging characteristics of the synovium, tenosynovium, joint fluid, bone tissue and bone marrow were evaluated using existing MRI scoring systems. Results: In 3/20 (15%) children, mild or moderate-severe synovial enhancement was observed and 2/20 (10%) children showed mild tenosynovial enhancement/thickening. Joint fluid (11/20 children; 55%), bony depressions (20/20 children; 100%) and medullary changes suggestive of bone marrow edema (6/20; 30%) were found in a substantial percentage of children. The most frequently observed combination of coexisting imaging characteristics was bony depressions with ≥2 mm joint fluid, which was found in 7/20 (35%) children. Simultaneous presence of synovial and tenosynovial enhancement/thickening, bony depressions and medullary changes suggestive of bone marrow edema was observed in one child. Conclusion: Several juvenile idiopathic arthritis-relevant MRI characteristics can be observed in the clinically non-inflamed symptomatic pediatric wrist.
AB - Background: Knowledge of the synovial and tenosynovial appearance of the clinically non-arthritic symptomatic juvenile wrist using contrast-enhanced magnetic resonance imaging (MRI) is sparse. Objectives: To analyze contrast-enhanced MRI findings of the clinically non-inflamed symptomatic pediatric wrist, focusing on the enhancing synovial and tenosynovial membrane. To evaluate the coexistent presence of (teno)synovial enhancement, joint fluid, bony depressions and medullary changes suggestive of bone marrow edema. Materials and methods: We included 20 children (15 girls; age range: 7.5–17.6 years) who underwent contrast-enhanced MRI of the wrist, based on initial clinical indication, and eventually turned out to be unaffected by arthritic or orthopedic disorders. Various imaging characteristics of the synovium, tenosynovium, joint fluid, bone tissue and bone marrow were evaluated using existing MRI scoring systems. Results: In 3/20 (15%) children, mild or moderate-severe synovial enhancement was observed and 2/20 (10%) children showed mild tenosynovial enhancement/thickening. Joint fluid (11/20 children; 55%), bony depressions (20/20 children; 100%) and medullary changes suggestive of bone marrow edema (6/20; 30%) were found in a substantial percentage of children. The most frequently observed combination of coexisting imaging characteristics was bony depressions with ≥2 mm joint fluid, which was found in 7/20 (35%) children. Simultaneous presence of synovial and tenosynovial enhancement/thickening, bony depressions and medullary changes suggestive of bone marrow edema was observed in one child. Conclusion: Several juvenile idiopathic arthritis-relevant MRI characteristics can be observed in the clinically non-inflamed symptomatic pediatric wrist.
KW - Adolescents
KW - Children
KW - Contrast enhancement
KW - Juvenile idiopathic arthritis
KW - Magnetic resonance imaging
KW - Synovial membrane
KW - Wrist joint
UR - http://www.scopus.com/inward/record.url?scp=85087751437&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00247-020-04739-5
DO - https://doi.org/10.1007/s00247-020-04739-5
M3 - Article
C2 - 32661590
SN - 0301-0449
VL - 50
SP - 1387
EP - 1396
JO - Pediatric Radiology
JF - Pediatric Radiology
IS - 10
ER -