Exploring contrast-enhanced MRI findings of the clinically non-inflamed symptomatic pediatric wrist.

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.

journal_name

Pediatr Radiol

journal_title

Pediatric radiology

authors

Verkuil F,van Gulik EC,Nusman CM,Barendregt AM,Nassar-Sheikh Rashid A,Schonenberg-Meinema D,Dolman KM,Maas M,Kuijpers TW,van den Berg JM,Hemke R

doi

10.1007/s00247-020-04739-5

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

1387-1396

issue

10

eissn

0301-0449

issn

1432-1998

pii

10.1007/s00247-020-04739-5

journal_volume

50

pub_type

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