scholarly journals Radiographs and MRI of the Cervical Spine in Juvenile Idiopathic Arthritis: A Cross-Sectional Retrospective Study

2021 ◽  
Vol 10 (24) ◽  
pp. 5798
Author(s):  
Mateusz Kotecki ◽  
Piotr Gietka ◽  
Magdalena Posadzy ◽  
Iwona Sudoł-Szopińska
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Cervical Spine ◽  
Retrospective Study ◽  
Laboratory Data ◽  
Clinical Signs ◽  
Imaging Findings ◽  
Axial Region ◽  
Cross Sectional ◽  
Soft Tissue Involvement ◽  
Joint Ankylosis

Background: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease among children. In some patients, cervical spine arthritis remains a serious and chronic manifestation of JIA. The aim of this study was to assess the frequency of cervical spine lesions on radiographs and MRI in JIA patients with clinical signs of cervical spine involvement and to verify if with the addition of MRI, the use of radiographs could be abandoned. Methods: This retrospective study evaluated consecutive 34 children (25 girls; aged 6–18 years, median 15.5 years) with JIA and with clinical involvement of cervical spine. In each patient, both radiographs and MRI of the cervical spine were performed. Imaging findings were correlated with clinical and laboratory data. Results: The cervical spine was affected in 35% of patients. The most frequent lesions were subaxial subluxations (SAS; 24%), apophyseal joint ankylosis (9%), and C1/C2 joint lesions (9%). Anterior atlanto-axial subluxation (AAS) was diagnosed only by radiography, and most of the SAS were seen on radiography, whereas only a few on MRI. Reversely, C1/C2 soft tissue involvement were seen on MRI only. Cervical spine involvement was associated with raised ESR (p = 0.012) and CRP (p = 0.014). Conclusions: The cervical spine lesions are still frequent complication of JIA affecting up to 35% of JIA patients. Most of them develop serious complications, such as AAS and ankylosis. Despite advantages of MRI in terms of the imaging of the atlanto-axial region radiography shows superiority in diagnosis of AAS and SAS.

scholarly journals Prevalence of Temporomandibular Disorder in children and adolescents with Juvenile Idiopathic Arthritis – a Norwegian cross sectional multicenter study

2020 ◽  
Author(s):  
Johannes Fischer ◽  
Marit Slåttelid Skeie ◽  
Karen Rosendahl ◽  
Karin Tylleskär ◽  
Stein Atle Lie ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Children And Adolescents ◽  
Multicenter Study ◽  
Temporomandibular Disorder ◽  
Clinical Signs ◽  
Masticatory Muscles ◽  
Health Examination ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Jaw Movement

Abstract Background. Children and adolescents with JIA may suffer pain from temporomandibular disorder (TMD) and routines for the assessment of temporomandibular joint (TMJ) pain for the health and dental care are lacking. The aims were to examine the prevalence of TMD in children and adolescents with juvenile idiopathic arthritis (JIA) as compared to their healthy peers and to examine potential associations between JIA and TMD.Methods. This comparative cross-sectional study is part of a longitudinal multicenter study performed during 2015 - 2020, including 228 children and adolescents aged 4-16 years, with a diagnosis of JIA according to the ILAR criteria. This sub-study draws on a subset of data from the first study visit, including assessments of TMD as part of a broader oral health examination. Participants with JIA were matched with healthy controls according to gender, age, and center site. Calibrated examiners performed the clinical oral examinations according to a standardized protocol, including shortened versions of diagnostic criteria for TMD (DC/TMD) and the former EuroTMJoint Recommendations for Clinical TMJ Assessment in Patients Diagnosed with JIA. Symptoms were recorded and followed by a clinical examination assessing the masticatory muscles and TMJ`s.Results. In our cohort of 221 participants with JIA and corresponding controls, 88 participants with JIA (39.8%) and 25 (11.3%) controls revealed TMD based on symptoms and clinical signs. Painful TMD during the last 30 days was reported in 59 (26.7%) participants with JIA vs. 10 (5.0%) of the healthy controls (p<0.001). Vertical unassisted jaw movement was lower in JIA than in controls; mean 46.2 mm vs. 49.0 mm, respectively (p <0.001). Among participants with JIA, a higher proportion of those using synthetic disease-modifying antirheumatic-drugs (sDMARDs) and biologic (bDMARDs) presented with painful masticatory muscle and TMJs at palpation.Conclusion. Symptoms or clinical signs of TMD were seen in approximately half of the JIA patients compared to about one fourth of their healthy peers. Painful palpation to masticatory muscles and decreased vertical unassisted jaw movement were more frequent in participants with JIA than among healthy controls and should be part of both medical and dental routine examinations in JIA.

scholarly journals Prevalence of temporomandibular disorder in children and adolescents with juvenile idiopathic arthritis – a Norwegian cross- sectional multicentre study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
J. Fischer ◽  
M. S. Skeie ◽  
K. Rosendahl ◽  
K. Tylleskär ◽  
S. Lie ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Children And Adolescents ◽  
Temporomandibular Disorder ◽  
Clinical Signs ◽  
Masticatory Muscles ◽  
Healthy Controls ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Cross Sectional ◽  
Disease Modifying

Abstract Background Children and adolescents with juvenile idiopathic arthritis (JIA) may suffer pain from temporomandibular disorder (TMD). Still, routines for the assessment of temporomandibular joint (TMJ) pain in health and dental care are lacking. The aims of this study were to examine the prevalence of TMD in children and adolescents with JIA compared to their healthy peers and to investigate potential associations between JIA and TMD. Methods This comparative cross-sectional study is part of a longitudinal multicentre study performed during 2015–2020, including 228 children and adolescents aged 4–16 years with a diagnosis of JIA according to the ILAR criteria. This particular substudy draws on a subset of data from the first study visit, including assessments of TMD as part of a broader oral health examination. Children and adolescents with JIA were matched with healthy controls according to gender, age, and centre site. Five calibrated examiners performed the clinical oral examinations according to a standardised protocol, including shortened versions of the diagnostic criteria for TMD (DC/TMD) and the TMJaw Recommendations for Clinical TMJ Assessment in Patients Diagnosed with JIA. Symptoms were recorded and followed by a clinical examination assessing the masticatory muscles and TMJs. Results In our cohort of 221 participants with JIA and 221 healthy controls, 88 (39.8%) participants with JIA and 25 (11.3%) healthy controls presented with TMD based on symptoms and clinical signs. Painful TMD during the last 30 days was reported in 59 (26.7%) participants with JIA vs. 10 (5.0%) of the healthy controls (p <  0.001). Vertical unassisted jaw movement was lower in participants with JIA than in controls, with means of 46.2 mm vs. 49.0 mm, respectively (p <  0.001). Among participants with JIA, a higher proportion of those using synthetic disease-modifying antirheumatic-drugs and biologic disease-modifying antirheumatic-drugs presented with painful masticatory muscles and TMJs at palpation. Conclusion Symptoms and clinical signs of TMD were seen in approximately half of the JIA patients compared to about one fourth of their healthy peers. Painful palpation to masticatory muscles and decreased vertical unassisted jaw movement were more frequent in participants with JIA than among healthy controls and should be part of both medical and dental routine examinations in patients with JIA.

scholarly journals Association of thrombocytopenia with splenomegaly in malaria patients in East Kalimantan: A cross-sectional, retrospective study

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1832
Author(s):  
Loly R.D. Siagian ◽  
Vera M. Lumbantoruan ◽  
Nurul Hasanah ◽  
Fransiska A. Sihotang ◽  
Carta Gunawan
Keyword(s):  
Retrospective Study ◽  
Laboratory Data ◽  
Public Hospitals ◽  
Common Finding ◽  
Severe Thrombocytopenia ◽  
Chi Square ◽  
Cross Sectional ◽  
Major Health Problem ◽  
East Kalimantan ◽  
Chi Square Test

Background: Malaria still presents as a major health problem in Indonesia and specifically in East Kalimantan. One common finding in malaria is thrombocytopenia, the mechanism of which is still unclear. Several studies have suggested some mechanisms, one of which is splenomegaly. This study aimed to discover the association between thrombocytopenia and splenomegaly of malaria patients in East Kalimantan. Methods: This study was a descriptive retrospective study with clinical and laboratory data obtained from the medical records of malaria patients in four major public hospitals from January 2015 to July 2018. The association between thrombocytopenia with splenomegaly was analysed using Chi-Square test. Results: A total of 215 patients were included; 189 male (87.9%) and 26 female (12.1%). The most common aetiology were Plasmodium vivax (43.2%), P. falciparum (42.8%), and mixed infection (P. falciparum and P. vivax) (4.6%). The distribution of thrombocyte count were normal in 28 patients (13%) and decreased in 187 patients (87%). Among patients with thrombocytopenia, the percentage of mild, moderate and severe thrombocytopenia was 18.2%, 43.8% and 33%, respectively. Splenomegaly was found in only 11 patients (5.1%). We found no association between thrombocytopenia with splenomegaly (p=0.61). Conclusions: We conclude that thrombocytopenia is not associated with splenomegaly in these malaria patients.

P017 Complications of Juvenile Idiopathic Arthritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
S Miladi ◽  
S Bouzid ◽  
A Fazaa ◽  
L Souabni ◽  
M Sellami ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Adverse Effects ◽  
Disease Onset ◽  
Clinical Signs ◽  
Membranous Glomerulonephritis ◽  
Cross Sectional Study ◽  
Chronic Inflammatory Disease ◽  
Cross Sectional ◽  
Renal Manifestation ◽  
The Mean

Abstract Background Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease characterized by onset before the age of 16. This term encompasses several disease categories, each of which has distinct methods of presentation, clinical signs, and prognosis. The study aimed to determine JIA complications in 51 patients. Methods A cross-sectional study including patients diagnosed with JIA according to ILAR criteria was conducted for 26 years [1995– 2021]. Epidemiological, clinical, therapeutic, and evolutive aspects were noted. Results Twenty-nine males and 22 females were included. The mean age of the disease onset was 7.6 years [1,5–16]. The mean age of patients at the time of the study was 23.29 years [9–45]. Polyarticular and seronegative form was the most frequent (34.5%). Other subtypes diagnosed were systemic (25%), enthesitis-related arthritis (21.2%), oligoarticular (12.5%), and seropositive polyarticular (5.8%). Standard X-Ray imaging showed articular damage in 50% of the cases. Hip arthritis was observed in 32% and surgery was needed in 16.9%. One patient presented with atlantoaxial subluxation. Growth retardation was noted in 28.6%. Cardiac manifestations were seen in 3 patients (pericarditis = 2, myocarditis = 1), uveitis in 3 cases, renal manifestation (extra membranous glomerulonephritis) in one patient with polyarticular form. One patient was diagnosed with multiple sclerosis. Small doses of corticosteroids were prescribed in 71.7%. Methotrexate was prescribed in 70.5% (interrupted for adverse effects in 3 patients), sulfasalazine in 30.6%, hydroxychloroquine in 5.7%, leflunomide in 15.4%. bDMARDs were needed in 16 patients: 14 patients received TNF alpha inhibitors, rituximab was prescribed for one patient with a polyarticular form, and tocilizumab in a patient with a systemic form. A switch of bDMARDs was conducted in 10 patients: for inefficiency in 4 cases and adverse effects in other 4 cases. Three patients developed uveitis under Etanercept, septicemia under Adalimumab, an allergic reaction, and depression under Infliximab. One patient died from a convulsive seizure at the age of 9. Conclusion The presence of complications is an additional burden to JIA patients. A multidisciplinary approach is required for the management of these complications.

scholarly journals Association of thrombocytopenia with splenomegaly in malaria patients in East Kalimantan: A cross-sectional, retrospective study

F1000Research ◽  
2019 ◽  
Vol 7 ◽  
pp. 1832
Author(s):  
Loly R.D. Siagian ◽  
Vera M. Lumbantoruan ◽  
Nurul Hasanah ◽  
Fransiska A. Sihotang ◽  
Carta Gunawan
Keyword(s):  
Plasmodium Falciparum ◽  
Retrospective Study ◽  
Plasmodium Vivax ◽  
Laboratory Data ◽  
Public Hospitals ◽  
Severe Thrombocytopenia ◽  
Chi Square ◽  
Cross Sectional ◽  
Major Health Problem ◽  
East Kalimantan

Background: Malaria still presents as a major health problem in Indonesia and specifically in East Kalimantan. One common sign found in malaria patient is thrombocytopenia, the mechanism of which is still unclear. Several studies have suggested some mechanisms, one of which is splenomegaly. This study aimed to discover the association between thrombocytopenia and splenomegaly of malaria patients in East Kalimantan. Methods: This study was a descriptive retrospective study with clinical and laboratory data obtained from the medical records of malaria patients in four major public hospitals from January 2015 to July 2018. The association between thrombocytopenia with splenomegaly was analysed using Chi-Square test. Results: A total of 215 patients were included; 189 male (87.9%) and 26 female (12.1%). The etiologic agents found in these patients were Plasmodium vivax (43.2%), Plasmodium falciparum (42.8%), and mixed infection (Plasmodium falciparum and Plasmodium vivax) (4.6%). The thrombocyte count was normal in 28 patients (13%) and decreased in 187 patients (87%). Among patients with thrombocytopenia, the percentage of mild, moderate and severe thrombocytopenia was 18.2%, 43.8% and 33%, respectively. Splenomegaly was found in only 11 patients (5.1%). We found no association between thrombocytopenia with splenomegaly (p=0.61). Conclusions: We conclude that splenomegaly, which was a rare clinical finding of these malaria patients, was not associated with thrombocytopenia.

CERVICAL SPINAL INJURY IN JUVENILE IDIOPATHIC ARTHRITIS: WHAT IS OVERLOOKED (THE FIRST-HAND EXPERIENCE AND THE BIBLIOGRAPHICAL REVIEW)

2021 ◽  
Vol 100 (2) ◽  
pp. 86-94
Author(s):  
R.K. Raupov ◽  
◽  
L.S. Sorokina ◽  
N.T. Garipova ◽  
M.S. Asadulaev ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Cervical Spine ◽  
Spinal Injury ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Genetically Engineered ◽  
Comparative Characteristic ◽  
Biological Drugs ◽  
Frequent Use ◽  
Clinically Significant

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood, in which involvement of the cervical spine (CS) can lead to clinically significant and irreversible functional impairment. Objective of the study: to provide a comparative characteristic of patients with JIA, depending on the presence of joint arthritis in cervical spine (CS). Materials and methods of the study: the retrospective uncontrolled continuous nonrandomized comparative study included data on patients with JIA (n=753) who were treated at the Clinic from 2007 to 2016. The diagnosis of JIA was diagnosed using ILAR criteria and all children were assessed for articular status. Disorders of the CS were diagnosed on the basis of clinical manifestations, as well as radiation studies. Results: clinical signs of CS injury were detected in 101 patients (13,4%) and were more common in patients with polyarticular (48%, OR=1,8 (1,2; 2,7), p<0,001) and systemic (18 ,9%, OR=3,6 [2,0; 6,6], p<0,001) variants of JIA. A statistically significant relationship has been found between arthritis of the CS and arthritis of the temporomandibular joints (TMJ) (OR=10,4 [5,4; 19,8], p<0,001), glenohumeral joints (OR=14,1 [7,5; 26,3], p<0,001). Patients with CS arthritis had a long disease duration and time to remission, high laboratory inflammatory activity, and the need for more frequent use of systemic glucocorticosteroids. Arthritis of the CS became an independent predictor of the need to use genetically engineered biological drugs (HR=1,78 (95% CI: 1,22; 2,59, p=0,002) and failure to achieve remission (HR=1,33 (95% CI: 1,01; 1,76 (p=0,04): Patients with arthritis of the CS had anterior chronic uveitis less often. Conclusion: all patients with JIA need functional tests to assess the state of the CS even in the absence of complaints. A radiation study of CS should be performed, as far as possible, on all children with polyarticular and systemic variants of JIA, as well as arthritis of TMJ and shoulder joint, unless there are risks of general anesthesia for younger patients.

scholarly journals Prevalence of temporomandibular disorder in children and adolescents with juvenile idiopathic arthritis – a Norwegian cross-sectional multicentre study

2020 ◽  
Author(s):  
Johannes Fischer ◽  
Marit Slåttelid Skeie ◽  
Karen Rosendahl ◽  
Karin Tylleskär ◽  
Stein Atle Lie ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Children And Adolescents ◽  
Temporomandibular Disorder ◽  
Clinical Signs ◽  
Masticatory Muscles ◽  
Healthy Controls ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Cross Sectional ◽  
Disease Modifying

Abstract Background. Children and adolescents with juvenile idiopathic arthritis (JIA) may suffer pain from temporomandibular disorder (TMD). Still, routines for the assessment of temporomandibular joint (TMJ) pain in health and dental care are lacking. The aims of this study were to examine the prevalence of TMD in children and adolescents with JIA compared to their healthy peers and to investigate potential associations between JIA and TMD. Methods. This comparative cross-sectional study is part of a longitudinal multicentre study performed during 2015–2020, including 228 children and adolescents aged 4–16 years with a diagnosis of JIA according to the ILAR criteria. This particular substudy draws on a subset of data from the first study visit, including assessments of TMD as part of a broader oral health examination. Children and adolescents with JIA were matched with healthy controls according to gender, age, and centre site. Five calibrated examiners performed the clinical oral examinations according to a standardised protocol, including shortened versions of the diagnostic criteria for TMD (DC/TMD) and the former EuroTMJoint Recommendations for Clinical TMJ Assessment in Patients Diagnosed with JIA. Symptoms were recorded and followed by a clinical examination assessing the masticatory muscles and TMJs. Results. In our cohort of 221 participants with JIA and 221 healthy controls, 88 (39.8%) participants with JIA and 25 (11.3%) healthycontrols presented with TMD based on symptoms and clinical signs. Painful TMD during the last 30 days was reported in 59 (26.7%) participants with JIA vs. 10 (5.0%) of the healthy controls (p < 0.001). Vertical unassisted jaw movement was lower in participants with JIA than in controls, with means of 46.2 mm vs. 49.0 mm, respectively (p < 0.001). Among participants with JIA, a higher proportion of those using synthetic disease-modifying antirheumatic-drugs and biologic disease-modifying antirheumatic-drugs presented with painful masticatory muscles and TMJs at palpation.Conclusion. Symptoms and clinical signs of TMD were seen in approximately half of the JIA patients compared to about one fourth of their healthy peers. Painful palpation to masticatory muscles and decreased vertical unassisted jaw movement were more frequent in participants with JIA than among healthy controls and should be part of both medical and dental routine examinations in patients with JIA.

scholarly journals Magnetic resonance imaging of temporomandibular joint in juvenile idiopathic arthritis

2020 ◽  
Vol 8 (5) ◽  
pp. 1848
Author(s):  
Namrita Sachdev ◽  
Yashvant Singh ◽  
Parikha Rampal ◽  
Sana .
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Joint Effusion ◽  
Facial Dysmorphism ◽  
Cross Sectional ◽  
Wide Range ◽  
Clinical Signs And Symptoms ◽  
Mri Changes ◽  
Sensitivity Specificity

Background: Juvenile Idiopathic Arthritis (JIA) is the most common autoimmune inflammatory synovial arthritis causing wide range of disability in children. The involvement of temporo-mandibular joint (TMJ) in JIA varies ranging from 17% to 87%. Unlike other synovial joints, the TM joint is particularly vulnerable to inflammatory damage as the mandibular growth plate is superficial. JIA is a clinical diagnosis and is characterized by synovial hyperplasia and inflammation leading to joint effusion. TMJ involvement is clinically difficult to assess and often goes untreated. Children with TMJ arthritis have mastication dysfunction and pain. Delayed detection and treatment leads to abnormalities like micrognathia, jaw deformity, facial dysmorphism and chewing problems. MRI is the most sensitive modality to diagnose synovitis and involvement of TMJ in children of JIA.Methods: A cross-sectional observational study was undertaken in 30 children diagnosed as JIA as per ILAE criteria. They were evaluated clinically followed by contrast enhanced MRI for evidence of TMJ arthritis.Results: Of the 60 joints evaluated, clinical involvement was found in 18 joints (10 patients). 12(66.7%) out of them had MRI changes. 3(7.1%) joints out of 42 asymptomatic joints had MRI changes. 13 joints had synovial hypertrophy, 8 joints showed bone erosions. Bone marrow edema was seen in 2 joints, with no evidence of cartilage involvement in any joint. The sensitivity, specificity, PPV and NPV of clinical examination to diagnose TMJ arthritis as compared to MRI was 80.0%, 86.7%, 66.7% and 92.7% respectively.Conclusions: With paucity of clinical signs and symptoms, early involvement of TMJ arthritis in children of JIA can be detected by MRI to prevent long term disability in patients.

scholarly journals Association of thrombocytopenia with splenomegaly in malaria patients in East Kalimantan: A cross-sectional, retrospective study

F1000Research ◽  
2019 ◽  
Vol 7 ◽  
pp. 1832
Author(s):  
Loly R.D. Siagian ◽  
Vera M. Lumbantoruan ◽  
Nurul Hasanah ◽  
Fransiska A. Sihotang ◽  
Carta Gunawan
Keyword(s):  
Plasmodium Falciparum ◽  
Retrospective Study ◽  
Plasmodium Vivax ◽  
Laboratory Data ◽  
Public Hospitals ◽  
Severe Thrombocytopenia ◽  
Chi Square ◽  
Cross Sectional ◽  
Major Health Problem ◽  
East Kalimantan

Background: Malaria still presents as a major health problem in Indonesia and specifically in East Kalimantan. One common sign found in malaria patient is thrombocytopenia, the mechanism of which is still unclear. Several studies have suggested some mechanisms, one of which is splenomegaly. This study aimed to discover the association between thrombocytopenia and splenomegaly of malaria patients in East Kalimantan. Methods: This study was a descriptive retrospective study with clinical and laboratory data obtained from the medical records of malaria patients in four major public hospitals from January 2015 to July 2018. The association between thrombocytopenia with splenomegaly was analysed using Chi-Square test. Results: A total of 215 patients were included; 189 male (87.9%) and 26 female (12.1%). The etiologic agents found in these patients were Plasmodium vivax (43.2%), Plasmodium falciparum (42.8%), and mixed infection (Plasmodium falciparum and Plasmodium vivax) (4.6%). The thrombocyte count was normal in 28 patients (13%) and decreased in 187 patients (87%). Among patients with thrombocytopenia, the percentage of mild, moderate and severe thrombocytopenia was 18.2%, 43.8% and 33%, respectively. Splenomegaly was found in only 11 patients (5.1%). We found no association between thrombocytopenia with splenomegaly (p=0.61). Conclusions: We conclude that thrombocytopenia is not associated with splenomegaly in these malaria patients.

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