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Diagnostic value of MRI of the sacroiliac joints in juvenile spondyloarthritis

NELE HERREGODS, Jo Dehoorne UGent, Jacob Jaremko, Rik Joos, Xenofon Baraliakos, Koenraad Verstraete UGent and Lennart Jans UGent (2016) JOURNAL OF THE BELGIAN SOCIETY OF RADIOLOGY. 100(1).
abstract
Early diagnosis of spondyloarthritis (SpA) is becoming more important as new medical treatment options have become available to treat inflammation and delay progression of the disease. Increasingly, magnetic resonance imaging (MRI) of the sacroiliac joints is obtained for early detection of inflammatory changes, as it shows active inflammatory and structural lesions of sacroiliitis long before radiographic changes become evident. MRI of the sacroiliac joints in children is a useful tool for suspected juvenile spondyloarthritis (JSpA), even though it is not yet included in the current pediatric classification systems. Recognizing MRI features of pediatric sacroiliitis is a challenge. As most radiologists are not familiar with the normal MRI appearance of the pediatric sacroiliac joint, clear definitions are mandatory. Actually, the adult Assessment of Spondyloarthritis International Society (ASAS) definition for sacroiliitis needs some adaptations for children. A proposal for a possible pediatric-specific definition for active sacroiliitis on MRI is presented in this review. Furthermore, MRI without contrast administration is sufficient to identify bone marrow edema (BME), capsulitis, and retroarticular enthesitis as features of active sacroiliitis in JSpA. In selected cases, when high short tau inversion recovery (STIR) signal in the joint is the only finding, gadolinium-enhanced images may help to confirm the presence of synovitis. Lastly, we found a high correlation between pelvic enthesitis and sacroiliitis on MRI of the sacroiliac joints in children. As pelvic enthesitis indicates active inflammation, it may play a role in assessment of the inflammatory status. Therefore, it should be carefully sought and noted when examining MRI of the sacroiliac joints in children.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
Diagnostic value, Juvenile spondyloarthritis, Magnetic resonance imaging, Sacroiliac joints, Sacroiliitis, ENTHESITIS-RELATED ARTHRITIS, MAGNETIC-RESONANCE, ANKYLOSING-SPONDYLITIS, IDIOPATHIC ARTHRITIS, ACTIVE SACROILIITIS, GADOLINIUM, CLASSIFICATION, RADIOGRAPHY, FEATURES, CHILDREN
journal title
JOURNAL OF THE BELGIAN SOCIETY OF RADIOLOGY
J. Belg. Soc. Radiol.
volume
100
issue
1
article number
95
pages
14 pages
Web of Science type
Article
Web of Science id
000390012100078
JCR category
RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
JCR impact factor
0.252 (2016)
JCR rank
123/126 (2016)
JCR quartile
4 (2016)
ISSN
1780-2393
DOI
10.5334/jbr-btr.1198
language
English
UGent publication?
yes
classification
A1
copyright statement
Creative Commons Attribution 4.0 International Public License (CC-BY 4.0)
id
8164641
handle
http://hdl.handle.net/1854/LU-8164641
date created
2016-11-23 12:01:54
date last changed
2017-09-18 08:23:34
@article{8164641,
  abstract     = {Early diagnosis of spondyloarthritis (SpA) is becoming more important as new medical treatment options have become available to treat inflammation and delay progression of the disease. Increasingly, magnetic resonance imaging (MRI) of the sacroiliac joints is obtained for early detection of inflammatory changes, as it shows active inflammatory and structural lesions of sacroiliitis long before radiographic changes become evident. MRI of the sacroiliac joints in children is a useful tool for suspected juvenile spondyloarthritis (JSpA), even though it is not yet included in the current pediatric classification systems. 
Recognizing MRI features of pediatric sacroiliitis is a challenge. As most radiologists are not familiar with the normal MRI appearance of the pediatric sacroiliac joint, clear definitions are mandatory. Actually, the adult Assessment of Spondyloarthritis International Society (ASAS) definition for sacroiliitis needs some adaptations for children. A proposal for a possible pediatric-specific definition for active sacroiliitis on MRI is presented in this review. Furthermore, MRI without contrast administration is sufficient to identify bone marrow edema (BME), capsulitis, and retroarticular enthesitis as features of active sacroiliitis in JSpA. In selected cases, when high short tau inversion recovery (STIR) signal in the joint is the only finding, gadolinium-enhanced images may help to confirm the presence of synovitis. 
Lastly, we found a high correlation between pelvic enthesitis and sacroiliitis on MRI of the sacroiliac joints in children. As pelvic enthesitis indicates active inflammation, it may play a role in assessment of the inflammatory status. Therefore, it should be carefully sought and noted when examining MRI of the sacroiliac joints in children.},
  articleno    = {95},
  author       = {HERREGODS, NELE and Dehoorne, Jo and Jaremko, Jacob and Joos, Rik and Baraliakos, Xenofon and Verstraete, Koenraad and Jans, Lennart},
  issn         = {1780-2393},
  journal      = {JOURNAL OF THE BELGIAN SOCIETY OF RADIOLOGY},
  keyword      = {Diagnostic value,Juvenile spondyloarthritis,Magnetic resonance imaging,Sacroiliac joints,Sacroiliitis,ENTHESITIS-RELATED ARTHRITIS,MAGNETIC-RESONANCE,ANKYLOSING-SPONDYLITIS,IDIOPATHIC ARTHRITIS,ACTIVE SACROILIITIS,GADOLINIUM,CLASSIFICATION,RADIOGRAPHY,FEATURES,CHILDREN},
  language     = {eng},
  number       = {1},
  pages        = {14},
  title        = {Diagnostic value of MRI of the sacroiliac joints in juvenile spondyloarthritis},
  url          = {http://dx.doi.org/10.5334/jbr-btr.1198},
  volume       = {100},
  year         = {2016},
}

Chicago
HERREGODS, NELE, Jo Dehoorne, Jacob Jaremko, Rik Joos, Xenofon Baraliakos, Koenraad Verstraete, and Lennart Jans. 2016. “Diagnostic Value of MRI of the Sacroiliac Joints in Juvenile Spondyloarthritis.” Journal of the Belgian Society of Radiology 100 (1).
APA
HERREGODS, N., Dehoorne, J., Jaremko, J., Joos, R., Baraliakos, X., Verstraete, K., & Jans, L. (2016). Diagnostic value of MRI of the sacroiliac joints in juvenile spondyloarthritis. JOURNAL OF THE BELGIAN SOCIETY OF RADIOLOGY, 100(1).
Vancouver
1.
HERREGODS N, Dehoorne J, Jaremko J, Joos R, Baraliakos X, Verstraete K, et al. Diagnostic value of MRI of the sacroiliac joints in juvenile spondyloarthritis. JOURNAL OF THE BELGIAN SOCIETY OF RADIOLOGY. 2016;100(1).
MLA
HERREGODS, NELE, Jo Dehoorne, Jacob Jaremko, et al. “Diagnostic Value of MRI of the Sacroiliac Joints in Juvenile Spondyloarthritis.” JOURNAL OF THE BELGIAN SOCIETY OF RADIOLOGY 100.1 (2016): n. pag. Print.