4.6 Review

Toward Developing a Semiquantitative Whole Body-MRI Scoring for Juvenile Idiopathic Arthritis: Critical Appraisal of the State of the Art, Challenges, and Opportunities

Journal

ACADEMIC RADIOLOGY
Volume 28, Issue 2, Pages 271-286

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.acra.2020.01.022

Keywords

Children; Contrast agent; Growing joints; Juvenile idiopathic arthritis; Magnetic resonance imaging; Scoring systems; Whole body

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The paper reviews the literature on the use of whole-body MRI in inflammatory arthritis and proposes the development of a pediatric WB-MRI scoring system for evaluation of JIA in the future.
With powerful new therapies available for management of juvenile idiopathic arthritis (JIA), early diagnosis leading to appropriate treatment may prevent long-term structural joint damage. Although magnetic resonance imaging (MRI) is typically used to assess individual body parts, indications for whole body (WB) MRI are increasing. Its utility as a diagnostic and monitoring tool has already been widely investigated in adult rheumatology patients, but less so in pediatric rheumatologic patients. This paper is a comprehensive review of scoring systems and a proposal for the conceptual development of a WB-MRI scoring system for the evaluation of JIA. In this review we identify, summarize, and critically appraise the available literature on the use of WB-MRI in inflammatory arthritis, addressing relevant considerations on components of a classification system that can lead to the development of a future pediatric WB-MRI scoring system for use in children with JIA. We also discuss advantages and challenges of developing such a WB-MRI scoring system for assessment of JIA and outline next steps toward the conceptual development of this scoring system.

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