Juvenile Idiopathic Arthritis

  • Etiology: Autoimmune inflammatory joint disease
  • Imaging Radiograph:
    — Osteoporosis most pronounced in periarticular region
    — Cartilage destruction and joint narrowing
    — Bony ankylosis is late manifestation
    — Epipyseal overgrowth due to hyperemia
    — Rice bodies in bursa
    — Tenosynovitis extensor dominance
    — Atlanto-axial rotatory subluxation
  • Imaging MRI:
    — Joint effusion
    — Thick synovium
    — Loose bodies
    — Epipyseal enlargement
  • DDX:
  • Complications:
  • Treatment:
  • Clinical:
    — Onset prior to 16 years old and most common in 1-3 years old
    — Lasts at least 6 weeks
    — Knee most commonly affected joint

Radiology Cases of Juvenile Idiopathic Arthritis

Radiology Cases of Juvenile Idiopathic Arthritis Causing Atlanto-axial Rotatory Subluxation

CT of atlanto-axial rotatory subluxation due to juvenile idiopathic arthritis
Axial images from a CT without contrast of the cervical spine shows the C1 vertebral body rotated to the left approximately 45 degrees (top) in relation to the C2 vertebral body (middle). A MIP image (bottom) better demonstrates the rotation of C1 on C2.

Radiology Cases of Juvenile Idiopathic Arthritis Causing Cartilage Destruction and Joint Narrowing

Radiograph of hand in juvenile idiopathic arthritis
AP radiographs of the hands shows bilateral periarticular osteoporosis throughout the hands. There is bilateral loss of the joint spaces in the carpal bones due to cartilage destruction and erosions at the proximal interphalangeal joints.