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- Title
Exploring contrast-enhanced MRI findings of the clinically non-inflamed symptomatic pediatric wrist.
- Authors
Verkuil, Floris; van Gulik, E. Charlotte; Nusman, Charlotte M.; Barendregt, Anouk M.; Nassar-Sheikh Rashid, Amara; Schonenberg-Meinema, Dieneke; Dolman, Koert M.; Maas, Mario; Kuijpers, Taco W.; van den Berg, J. Merlijn; Hemke, Robert
- 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.
- Subjects
CONTRAST-enhanced magnetic resonance imaging; SYNOVIAL fluid; WRIST; SYNOVIAL membranes; BONE marrow; JUVENILE diseases
- Publication
Pediatric Radiology, 2020, Vol 50, Issue 10, p1387
- ISSN
0301-0449
- Publication type
Article
- DOI
10.1007/s00247-020-04739-5