scholarly journals Outcomes in Juvenile-Onset Spondyloarthritis

2021 ◽  
Vol 8 ◽  
Author(s):  
Judith A. Smith ◽  
Ruben Burgos-Vargas
Keyword(s):  
Prognostic Indicators ◽  
Tnf Inhibitor ◽  
Resonance Imaging ◽  
Juvenile Onset ◽  
Clinical Burden ◽  
Axial Disease ◽  
Magnetic Resonance Imaging Mri ◽  
Active Inflammation ◽  
Active Disease ◽  
Game Changer

Some studies have suggested children with juvenile onset spondyloarthritis (JoSpA) have a relatively poor outcome compared to other juvenile idiopathic arthritis (JIA) categories, in regards to functional status and failure to attain remission. Thus, in the interest of earlier recognition and risk stratification, awareness of the unique characteristics of this group is critical. Herein, we review the clinical burden of disease, prognostic indicators and outcomes in JoSpA. Of note, although children exhibit less axial disease at onset compared to adults with spondyloarthritis (SpA), 34–62% have magnetic resonance imaging (MRI) evidence for active inflammation in the absence of reported back pain. Furthermore, some studies have reported that more than half of children with “enthesitis related arthritis” (ERA) develop axial disease within 5 years of diagnosis. Axial disease, and more specifically sacroiliitis, portends continued active disease. The advent of TNF inhibitors has promised to be a “game changer,” given their relatively high efficacy for enthesitis and axial disease. However, the real world experience in various cohorts since the introduction of more widespread TNF inhibitor usage, in which greater than a third still have persistently active disease, suggests there is still work to be done in developing new therapies and improving the outlook for JoSpA.

Inflammatory Spinal Disease in Psoriatic Arthritis: A Report from the GRAPPA 2010 Annual Meeting

2012 ◽  
Vol 39 (2) ◽  
pp. 418-420 ◽  
Author(s):  
DAFNA D. GLADMAN
Keyword(s):  
Back Pain ◽  
Psoriatic Arthritis ◽  
Clinical Symptoms ◽  
Inflammatory Back Pain ◽  
Resonance Imaging ◽  
Spinal Disease ◽  
Sacroiliac Joints ◽  
Axial Disease ◽  
Magnetic Resonance Imaging Mri ◽  
Ankylosing Spondyloarthritis

Diagnosing axial disease in patients with psoriatic arthritis (PsA) has been largely dependent on identifying inflammatory back pain (IBP), which itself has been difficult to define. We review the criteria used to identify IBP in patients with ankylosing spondylitis (AS) and other forms of spondyloarthritis. Recently, the Ankylosing SpondyloArthritis International Society (ASAS) developed a list of clinical and radiographic criteria for identifying IBP in patients with AS. However, it is more difficult to identify IBP in patients with PsA because generally they have less pain than patients with rheumatoid arthritis or AS. Further, PsA patients may have clinical symptoms of pain but negative radiographs. It may be more useful to identify sacroiliitis or syndesmophytes by magnetic resonance imaging (MRI), since MRI identifies lesions in the sacroiliac joints and the spine much earlier than can be detected on radiographs. In summary, all patients with PsA should be assessed for axial involvement with history, physical examination, and imaging. Patients with psoriasis whose history includes onset of back pain before age 40 years, the presence of night pain, and improvement with exercise but not with rest, or who have limited neck or back mobility, should be referred to a rheumatologist.

Sacroiliitis in Axial Spondyloarthritis: Assessing Morphology and Activity

2018 ◽  
Vol 22 (02) ◽  
pp. 180-188 ◽  
Author(s):  
Niels Egund ◽  
Iris Eshed ◽  
Iwona Sudoł-Szopińska ◽  
Anne Jurik ◽  
Lennart Jans
Keyword(s):  
Structural Changes ◽  
Bone Marrow Edema ◽  
Axial Spondyloarthritis ◽  
Resonance Imaging ◽  
Sacroiliac Joints ◽  
Mri Features ◽  
Magnetic Resonance Imaging Mri ◽  
Active Inflammation ◽  
Marrow Edema

Objective To review the strengths, limitations, and new insights in the anatomy and magnetic resonance imaging (MRI) features of active and structural lesions of sacroiliitis in spondyloarthritis. Discussion MRI plays a key role in the diagnosis and follow-up of sacroiliitis in spondyloarthritis. MRI of the sacroiliac joints in affected patients may show active lesions such as bone marrow edema, capsulitis, enthesitis, or synovitis as well as structural changes such as erosion, fat infiltration, sclerosis, backfill, and ankylosis. Active lesions of sacroiliitis on MRI are particularly important for the diagnosis and assessment of ongoing active inflammation. Structural lesions increasingly gain importance for diagnosis and follow-up. Conclusion Active lesions remain the hallmark for assessment of inflammation in sacroiliitis. Structural lesions increasingly play a role in the diagnosis of spondyloarthritis.

Top-Ten Tips for Imaging the Brachial Plexus with Ultrasound and MRI

2019 ◽  
Vol 23 (04) ◽  
pp. 405-418 ◽  
Author(s):  
James F. Griffith ◽  
Radhesh Krishna Lalam
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Brachial Plexus ◽  
Muscle Denervation ◽  
Resonance Imaging ◽  
Neural Injury ◽  
Clinical Indications ◽  
Magnetic Resonance Imaging Mri ◽  
High Level ◽  
Extensive Involvement

AbstractWhen it comes to examining the brachial plexus, ultrasound (US) and magnetic resonance imaging (MRI) are complementary investigations. US is well placed for screening most extraforaminal pathologies, whereas MRI is more sensitive and accurate for specific clinical indications. For example, MRI is probably the preferred technique for assessment of trauma because it enables a thorough evaluation of both the intraspinal and extraspinal elements, although US can depict extraforaminal neural injury with a high level of accuracy. Conversely, US is probably the preferred technique for examination of neurologic amyotrophy because a more extensive involvement beyond the brachial plexus is the norm, although MRI is more sensitive than US for evaluating muscle denervation associated with this entity. With this synergy in mind, this review highlights the tips for examining the brachial plexus with US and MRI.

Use of Magnetic Resonance Imaging (MRI) to Determine the 3D Geometry in the Human Rectum

Endoscopy ◽  
2004 ◽  
Vol 36 (10) ◽  
Author(s):  
BP McMahon ◽  
JB Frøkjær ◽  
A Bergmann ◽  
DH Liao ◽  
E Steffensen ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
3D Geometry ◽  
Human Rectum ◽  
Magnetic Resonance Imaging Mri

Improved Contrast in Ultra-Low-Field MRI with Time-Dependent Bipolar Prepolarizing Fields: Theory and NMR Demonstrations

2013 ◽  
Vol 20 (3) ◽  
pp. 327-336 ◽  
Author(s):  
Jaakko O. Nieminen ◽  
Jens Voigt ◽  
Stefan Hartwig ◽  
Hans Jürgen Scheer ◽  
Martin Burghoff ◽  
...  
Keyword(s):  
Field Strength ◽  
Time Course ◽  
Signal Strength ◽  
Relaxation Rates ◽  
Resonance Imaging ◽  
New Approach ◽  
Spin Lattice ◽  
Low Field ◽  
Low Field Mri ◽  
Magnetic Resonance Imaging Mri

Abstract The spin-lattice (T1) relaxation rates of materials depend on the strength of the external magnetic field in which the relaxation occurs. This T1 dispersion has been suggested to offer a means to discriminate between healthy and cancerous tissue by performing magnetic resonance imaging (MRI) at low magnetic fields. In prepolarized ultra-low-field (ULF) MRI, spin precession is detected in fields of the order of 10-100 μT. To increase the signal strength, the sample is first magnetized with a relatively strong polarizing field. Typically, the polarizing field is kept constant during the polarization period. However, in ULF MRI, the polarizing-field strength can be easily varied to produce a desired time course. This paper describes how a novel variation of the polarizing-field strength and duration can optimize the contrast between two types of tissue having different T1 relaxation dispersions. In addition, NMR experiments showing that the principle works in practice are presented. The described procedure may become a key component for a promising new approach of MRI at ultra-low fields

Magnetic resonance imaging in study of lungs

2019 ◽  
pp. 10-23
Author(s):  
T. A. Akhadov ◽  
S. Yu. Guryakov ◽  
M. V. Ublinsky
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Medical Society ◽  
Resonance Imaging ◽  
Iodinated Contrast ◽  
Long Time ◽  
Women And Children ◽  
Magnetic Resonance Imaging Mri ◽  
A Current ◽  
Lung Mri

For a long time, there was a need to apply magnetic resonance imaging (MRI) technique for lung visualization in clinical practice. The development of this method is stimulated by necessity of the emergence of an alternative to computed tomography, especially when radiation and injection of iodine-containing contrast agents are contraindicated or undesirable, for example, in pregnant women and children, people with intolerance to iodinated contrast. One of the reasons why lung MRI is still rarely used is lack of elaborated standardized protocols that would be adapted to clinical needs of medical society. This publication is a current literature review on the use of MRI in lung studies.

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