scholarly journals Juvenile Idiopathic Arthritis: A Review of Novel Diagnostic and Monitoring Technologies

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1683
Author(s):  
Amelia J. Garner ◽  
Reza Saatchi ◽  
Oliver Ward ◽  
Daniel P. Hawley
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Functional Disability ◽  
Three Dimensional ◽  
Joint Damage ◽  
Joint Inflammation ◽  
Infrared Thermal Imaging ◽  
Insidious Onset ◽  
Assessment And Monitoring ◽  
Monitoring Technologies ◽  
Tools And Techniques

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood and is characterized by an often insidious onset and a chronic relapsing–remitting course, once diagnosed. With successive flares of joint inflammation, joint damage accrues, often associated with pain and functional disability. The progressive nature and potential for chronic damage and disability caused by JIA emphasizes the critical need for a prompt and accurate diagnosis. This article provides a review of recent studies related to diagnosis, monitoring and management of JIA and outlines recent novel tools and techniques (infrared thermal imaging, three-dimensional imaging, accelerometry, artificial neural networks and fuzzy logic) which have demonstrated potential value in assessment and monitoring of JIA. The emergence of novel techniques to assist clinicians’ assessments for diagnosis and monitoring of JIA has demonstrated promise; however, further research is required to confirm their clinical utility.

Three-Dimensional Natural Convection From Vertical Heated Plates With Adjoining Cool Surfaces

1992 ◽  
Vol 114 (1) ◽  
pp. 115-120 ◽  
Author(s):  
B. W. Webb ◽  
T. L. Bergman
Keyword(s):  
Heat Transfer ◽  
Natural Convection ◽  
Control Volume ◽  
Three Dimensional ◽  
Local Heat Transfer ◽  
Local Heat ◽  
Uniform Heat Flux ◽  
Infrared Thermal Imaging ◽  
Transfer Rates ◽  
Thermal Boundary Conditions

Natural convection in an enclosure with a uniform heat flux on two vertical surfaces and constant temperature at the adjoining walls has been investigated both experimentally and theoretically. The thermal boundary conditions and enclosure geometry render the buoyancy-induced flow and heat transfer inherently three dimensional. The experimental measurements include temperature distributions of the isoflux walls obtained using an infrared thermal imaging technique, while the three-dimensional equations governing conservation of mass, momentum, and energy were solved using a control volume-based finite difference scheme. Measurements and predictions are in good agreement and the model predictions reveal strongly three-dimensional flow in the enclosure, as well as high local heat transfer rates at the edges of the isoflux wall. Predicted average heat transfer rates were correlated over a range of the relevant dimensionless parameters.

Do Radiographic Joint Damage and Disease Activity Influence Functional Disability Through Different Mechanisms? Direct and Indirect Effects of Disease Activity in Established Rheumatoid Arthritis

2013 ◽  
Vol 40 (9) ◽  
pp. 1505-1512 ◽  
Author(s):  
Sandhya C. Nair ◽  
Johannes W.J. Bijlsma ◽  
Jacobien H. van der Werf ◽  
Maaike J. van der Veen ◽  
Suzanne P. Linn-Rasker ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Functional Disability ◽  
Functional Decline ◽  
Joint Damage ◽  
Treatment Strategies ◽  
Joint Disease ◽  
Influence Functional ◽  
Over Time ◽  
Predictive Effect

Objective.To explore the relationship between rheumatoid arthritis (RA) disease activity and functional disability over time, considering indirect (predictive) and direct (concurrent) associations as well as the influence of radiographic joint damage and treatment strategy.Methods.Functional disability [Health Assessment Questionnaire (HAQ)], disease activity [28-joint Disease Activity Score (DAS28)], and radiographic joint damage [Sharp/van der Heijde score (SHS)] were measured in 4 consecutive randomized controlled trials with increasingly intensive (tight control) treatment strategies. Average followup time for the 3 cohorts was 97, 53, and 50 months, respectively. Next to current DAS28, the previous DAS28 was used to study the predictive effect of a change in DAS28 on progression of functional disability (HAQ). Finally, it was investigated whether SHS mediated the predictive effect of DAS28.Results.In patients treated with intensive treatment strategies, the progression of HAQ over time was statistically significantly less (p < 0.0001). The predictive influence of DAS28 on HAQ progression increased over the duration of the disease. SHS was not found to influence HAQ progression and did not mediate the predictive effect of DAS28. In the less intensively treated patients, the direct effect of disease activity decreased with disease duration, and contrarily, SHS did influence HAQ progression, but was not found to (fully) mediate the predictive effect of DAS28.Conclusion.In patients with RA treated with modern treatment strategies, there is less functional decline over time. Further, disease activity does predict functional decline but joint damage does not. This might indicate that factors associated with cumulative disease activity but not visible on radiographs can influence functional decline in patients with RA. This further underlines the importance of disease activity as a treatment target in early RA and in established RA.

scholarly journals Juvenile Idiopathic Arthritis

2021 ◽  
Author(s):  
Vadood Javadi Parvaneh ◽  
Khosro Rahmani
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Early Diagnosis ◽  
Joint Destruction ◽  
Joint Inflammation ◽  
Aggressive Treatment ◽  
Synovial Joint ◽  
Management Options ◽  
Biologic Dmards ◽  
Appropriate Treatment ◽  
Outcomes For Children

Juvenile idiopathic arthritis (JIA) is the most common form of chronic synovial joint inflammation in children. It potentially leads to disability and psychosocial outcomes for children and their families. In the absence of appropriate treatment, this can lead to joint destruction and disability. Thus, early diagnosis and aggressive treatment are essential. With the presentation of new biologic DMARDs, based on understanding the disease pathophysiology and molecular pathogenesis, the course of the disease and its outcome have been changed profoundly. In this chapter, the early diagnosis, appropriate treatment, and outcomes approaches are described. These include the latest diagnosis and management options.

scholarly journals Understanding the Mechanisms of Pain in Rheumatoid Arthritis

2020 ◽  
Author(s):  
Kathryn Biddle ◽  
Nidhi Sofat
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Damage ◽  
Joint Inflammation ◽  
Long Term Follow Up ◽  
Important Symptom ◽  
Ongoing Pain ◽  
Disease Modifying Agents

Pain is a debilitating feature of rheumatoid arthritis (RA) and is often described by patients as their most important symptom. Rheumatoid arthritis pain has traditionally been attributed solely to joint inflammation, however despite the advent of increasingly effective disease modifying agents, patients continue to report pain at long term follow up. The cause for ongoing pain is multifactorial and includes joint damage and pain sensitisation. In this book chapter, we will describe the mechanisms underlying the distinct components of pain which are manifest in rheumatoid arthritis and discuss why a thorough assessment of pain is vital to target treatments appropriately.

Development and preliminary validation of a paediatric-targeted MRI scoring system for the assessment of disease activity and damage in juvenile idiopathic arthritis

2010 ◽  
Vol 70 (3) ◽  
pp. 440-446 ◽  
Author(s):  
Clara Malattia ◽  
Maria Beatrice Damasio ◽  
Angela Pistorio ◽  
Maka Ioseliani ◽  
Iris Vilca ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Construct Validity ◽  
Disease Activity ◽  
Scoring System ◽  
Bone Erosion ◽  
Joint Damage ◽  
Targeted Mri ◽  
Mri Score ◽  
Responsiveness To Change ◽  
Assessment Of Disease Activity

ObjectivesTo develop and validate a paediatric-targeted MRI scoring system for the assessment of disease activity and damage in juvenile idiopathic arthritis (JIA). To compare the paediatric MRI score with the adult-designed. Outcome Measures in Rheumatology Clinical Trials—Rheumatoid Arthritis MRI Score (RAMRIS), whose suitability for assessing growing joints was tested.MethodsIn 66 patients with JIA the clinically more affected wrist was studied. Thirty-nine patients had a 1-year MRI follow-up. Two readers independently assigned the paediatric score and the RAMRIS to all studies. Validation procedures included analysis of reliability, construct validity and responsiveness to change. A reduced version of the bone erosion score was also developed and tested.ResultsThe paediatric score showed an excellent reproducibility (interclass correlation coefficient >0.9). The interobserver agreement of RAMRIS was moderate for bone erosions and excellent for bone marrow oedema (BMO). The paediatric score and RAMRIS provided similar results for construct validity. The responsiveness to change of the paediatric score was moderate for synovitis and bone erosion, and poor for BMO and did not improve when RAMRIS was applied. The reduced version of the bone erosion was valuable for the assessment of joint damage, and provided time-saving advantages.ConclusionThe results demonstrate that the paediatric MRI score is a reliable and valid method for assessing disease activity and damage in JIA. Unexpectedly, the RAMRIS provides acceptable suitability for use in the paediatric age group. Further work, especially in a longitudinal setting, is required before defining the most suitable MRI scale for assessing growing joints.

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