Exploring contrast-enhanced MRI findings of the clinically non-inflamed symptomatic pediatric wrist
Male
Wrist Joint
2. Zero hunger
Adolescent
Synovial Membrane
Contrast Media
Magnetic Resonance Imaging
3. Good health
03 medical and health sciences
0302 clinical medicine
Image Interpretation, Computer-Assisted
Organometallic Compounds
Edema
Humans
Original Article
Female
Prospective Studies
Registries
Joint Diseases
Child
Bone Marrow Diseases
Netherlands
DOI:
10.1007/s00247-020-04739-5
Publication Date:
2020-07-13T13:03:52Z
AUTHORS (11)
ABSTRACT
Abstract
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.
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