Juvenil i̇diyopatik artritte görüntüleme yöntemleri

Juvenile idiopathic arthritis (JIA) is a heterogeneous group of diseases characterized by synovial inflammation and is the most common rheumatic disease in children. Radiological assessment has been a beneficial method for investigating the progress and outcome of chronic inflammatory arthritis for many years. Imaging of JIA is necessary for initial diagnosis, monitoring disease activity and management responses, and determining the complications. Imaging in patients with JIA has mostly relied on radiography. However, radiographic findings of active inflammation are nonspecific. During the last decade new therapeutic drugs have become available, so there is need for accurate monitoring of therapeutic response on damages to the joint. Both magnetic resonance imaging (MRI) and ultrasonography (US) are well suited for this application and are playing an increasingly important role in diagnosis and monitoring. US is also the best available technique for imaging guidance of steroid injections. MRI is the most sensitive technique for the detection of synovitis and is the only modality that can help detect bone marrow edema, both of which indicate active inflammation. US is more sensitive than radiography for the detection of synovial proliferation and effusions and is particularly useful in the evaluation of small peripheral joints. This review summaries the current information on radiography, US and MRI in JIA and highlights the advantages and limitations of each imaging modality.