PDF(Pubmed)
Abstract：
Juvenile idiopathic arthritis (JIA) is a collective term for pediatric inflammatory arthritis of unknown etiology, which presents diverse clinical and imaging findings. The pathogenesis is complex; however, most cases stem from an autoimmune mechanism. Herein we provide a short review of imaging findings of JIA. Imaging assessment begins with plain radiography demonstrating joint swelling, periarticular osteopenia, and juxtaarticular bone erosion. Bone erosion occurs later in JIA. Instead, aberrant epimetaphyseal growth often gives the first clue to the diagnosis. US and MRI can demonstrate the details of the synovium, cartilage, and subchondral bone. JIA is subdivided into oligoarthritis, polyarthritis (rheumatoid factor-negative and positive), psoriatic arthritis, enthesitis-related arthritis, and systemic JIA. Awareness of the different clinical characteristics, pathogenic background, and prognosis of each subtype facilitates a more advanced, imaging-based diagnosis. Unlike the other types, systemic JIA is an autoinflammatory disease accompanied by inflammatory cytokinemia and systemic symptoms stemming from aberrant activation of the innate immunity. Other autoinflammatory diseases, both monogenic (e.g., NOMID/CINCA) and multifactorial (e.g., CRMO), are also discussed.
摘要：
幼年特发性关节炎（JIA）是病因不明的儿童炎症性关节炎的统称，呈现不同的临床和影像学发现。发病机制复杂；然而，大多数病例源于自身免疫机制。在此，我们提供了JIA的影像学发现的简短回顾。影像学评估从X线平片开始，显示关节肿胀，关节周围骨质减少，和关节旁骨侵蚀。骨侵蚀发生在JIA后期。相反，异常的表皮干蛋白生长通常为诊断提供第一线索。US和MRI可以显示滑膜的细节，软骨，和软骨下骨.JIA被细分为少关节炎，多关节炎（类风湿因子阴性和阳性），银屑病关节炎,附着性关节炎,和系统性JIA。认识到不同的临床特点，致病背景，每种亚型的预后都有助于更晚期，基于成像的诊断。与其他类型不同，全身性JIA是一种自身炎症性疾病，伴有炎症性细胞因子血症和源自先天免疫异常激活的全身性症状。其他自身炎症性疾病，都是单基因的(例如，NOMID/CINCA)和多因素(例如，CRMO)，也讨论了。
