Handa Atsuhiko,  Bedoya M. Alejandra,  Iwasaka-neder Jade,  Johnston Patrick,  Bixby Sarah

Final Pr. ID: Poster #: SCI-019

To assess the equivalence of MRI without Gd-based contrast and MRI with contrast in the evaluation of synovitis in pediatric patients with juvenile idiopathic arthritis (JIA).

Contrast-enhanced imaging has been the gold-standard for MR evaluation of synovitis in patients with JIA (JAMRIS system). Conventional 2D MRI sequences did not allow reliable differentiation between synovium vs joint fluid. With higher field-strength magnets (1.5T or 3T), and high-resolution 3D sequences, the synovium may be differentiated from joint fluid on noncontrast MRI. Read More

Authors:  Handa Atsuhiko , Bedoya M. Alejandra , Iwasaka-neder Jade , Johnston Patrick , Bixby Sarah

Keywords:  arthritis, MRI, contrast

Grimm Elizabeth,  Law Emily,  Luo Yu

Final Pr. ID: Poster #: EDU-015

Arthritis in pediatric patients presents a range of diagnostic challenges, including conditions such as septic arthritis, inflammatory arthritis, idiopathic chondrolysis, toxic synovitis, Lyme arthritis, and hemophilic arthritis. These conditions often share overlapping clinical and imaging features, complicating accurate diagnosis. However, key differences in clinical presentation and imaging findings can aid in differentiation. For instance, both septic arthritis and inflammatory arthritis may present with joint pain, swelling, and limited range of motion, with ultrasound commonly revealing joint effusion. Septic arthritis is typically characterized by an acute onset, high fever, elevated white blood cell (WBC) count, and significantly increased inflammatory markers. MRI findings often include complex joint effusions, synovial thickening, and periarticular bone marrow edema, with advanced cases showing periarticular myositis or pyomyositis and osteomyelitis involvement. In contrast, inflammatory arthritis usually presents with gradual onset, low-grade fever, and minimal WBC elevation, with MRI findings of symmetric or asymmetric synovial thickening, synovial enhancement, pannus formation, and mild to none surrounding muscular or bony involvement.
This educational exhibit aims to review the epidemiology of pediatric arthritis, including septic arthritis, inflammatory arthritis, idiopathic chondrolysis, toxic synovitis, Lyme arthritis, and hemophilic arthritis. It will discuss appropriate imaging protocols and highlight key clinical and imaging features that distinguish each arthritis, enhancing diagnostic accuracy and optimizing patient management. Read More

Authors:  Grimm Elizabeth , Law Emily , Luo Yu

Keywords:  Septic Arthritis, MR, Infection

Panwar Jyoti,  Kirkhus Eva,  Meyers Arthur,  Patel Hiten,  Van Rossum Marion,  Stimec Jennifer,  Tse Shirley,  Twilt Marinka,  Tzaribachev Nikolay,  Doria Andrea,  Tolend Mirkamal,  Akikusa Jonathan,  Herregods Nele,  Highmore Kerri,  Inarejos Clemente Emilio,  Jans Lennart,  Jaremko Jacob Lester,  Von Kalle Thekla

Final Pr. ID: Poster #: SCI-036

Whole body (WB) MRI is a valuable method for surveying the overall burden of systemic diseases such as juvenile idiopathic arthritis (JIA), directing further diagnostic and treatment approaches. Consensus-driven development and validation of a standardized WB-MRI scoring system for JIA has important clinical utility in timely detection and monitoring of disease activity, and serves as an outcome measure in research. We describe our experience utilizing a formal consensus approach amongst imaging and/or clinical JIA experts towards developing a novel WB MRI scoring system to assess disease activity in JIA. Read More

Authors:  Panwar Jyoti , Kirkhus Eva , Meyers Arthur , Patel Hiten , Van Rossum Marion , Stimec Jennifer , Tse Shirley , Twilt Marinka , Tzaribachev Nikolay , Doria Andrea , Tolend Mirkamal , Akikusa Jonathan , Herregods Nele , Highmore Kerri , Inarejos Clemente Emilio , Jans Lennart , Jaremko Jacob Lester , Von Kalle Thekla

Keywords:  Consensus, WB-MRI scoring system, Juvenile idiopathic arthritis

Junhasavasdikul Thitiporn,  Kellenberger Christian,  Tolend Mirkamal,  Doria Andrea

Final Pr. ID: Poster #: EDU-107

Juvenile Idiopathic Arthritis (JIA) is the most common musculoskeletal disorder in children. The temporomandibular joints (TMJs) are involved in majority of cases, and detection of early arthritic changes in these joints relies on contrast enhanced magnetic resonance imaging (MRI). However, with the paucity of evidence and consensus on the normal and pathologic changes in this small but complex joint, interpretation of TMJ MRIs remains to be difficult. This exhibit presents the normal growth related and arthritis related variations in the disease progression in TMJ MRIs of JIA patients. Read More

Authors:  Junhasavasdikul Thitiporn , Kellenberger Christian , Tolend Mirkamal , Doria Andrea

Keywords:  Temporomandibular joint, Juvenile idiopathic arthritis, Magnetic resonance imaging atlas

Stanley Parker,  Rubesova Erika

Final Pr. ID: Poster #: EDU-013 (T)

Introduction: Juvenile Idiopathic Arthritis (JIA) is the most common rheumatic entity in children and the second most common cause of musculoskeletal symptoms in pediatric patients. Treatment of JIA largely depends on frequently managing inflammation within the joints, and as such, ultrasound is a prime imaging modality that can be used for detection and monitoring of inflammation. Ultrasound is more sensitive than plain films in the early detection of JIA, and ultrasound is more sensitive than clinical examinations alone. As a low-cost, high-resolution imaging modality, ultrasound allows visualization of the joint spaces, can be used to detect joint effusions, and can monitor synovial proliferation and joint hyperemia, all while not exposing the patient to radiation. We will present ultrasound images of various joints in children such as knees, ankles, wrists, hands and feet. Ultrasound technique, imaging planes, choice of probes frequencies and ultrasound settings are analyzed for optimization of the images. This presentation will highlight the diagnostic imaging findings of JIA on ultrasound, such the presence of joint effusions, synovial proliferation, capsular thickening, tendinitis as well as provide information on common pitfalls associated with age-specific appearances of pediatric musculoskeletal structures on ultrasound. Familiarity with JIA and musculoskeletal ultrasound findings will allow timely diagnosis and implementation of appropriate treatment strategies. Read More

Authors:  Stanley Parker , Rubesova Erika

Keywords:  Juvenile Arthritis, Ultrasound, Musculoskeletal

Tierradentro-garcia Luis,  Alizai Hamza

Final Pr. ID: Poster #: EDU-058

Background:

Juvenile idiopathic arthritis (JIA) is the most common rheumatic condition in the pediatric population, with a prevalence of up to 150 cases per 100,000 children. Although the diagnosis of JIA is clinical, imaging plays a crucial role in the monitoring and stratification of disease, such as detecting growth disturbances, chronic joint structural changes, or treatment response. Conventional radiography has low accuracy for detection of acute synovitis or enthesitis, whereas ultrasound provides real-time assessment of inflammatory changes. Magnetic resonance imaging (MRI) is the most sensitive modality to discern early inflammatory or destructive changes in JIA, with the potential to visualize soft tissue and osteochondral abnormalities.

Education goals:

1) To describe the diagnostic criteria for the 7 subtypes of JIA.
2) To illustrate the more common imaging findings in JIA (e.g. swelling, bone mineral density, loss of joint space, erosions, growth disturbances, joint malalignment, ankylosis, enthesitis) using conventional radiography, ultrasound, and MRI.
3) To highlight the importance of early imaging changes that can support the clinical diagnosis of JIA.
4) To present the role of multimodality imaging in the evaluation of complex joint involvement (e.g. atlanto-occipital, atlanto-axial, temporomandibular, spinal, sacroiliac) in JIA.
5) To emphasize the role of imaging in characterizing conditions that can mimic JIA. Read More

Authors:  Tierradentro-garcia Luis , Alizai Hamza

Keywords:  Juvenile Idiopathic Arthritis, Multimodality, Rheumatology

Otobo Tarimobo,  Rumsy Dax,  Inarejos Emilio,  Kirkhus Eva,  Stimec Jennifer,  Panwar Jyoti,  Thorpe Kevin,  Jans Lennart,  Van Rossum Marion,  Tolend Mirkamal,  Perez Manuela,  Conaghan Philip,  Tzaribachev Nikolay,  Sandhya Pulukool,  Tse Shirley,  Simone Appenzeller,  Swami Vimarsha,  Touma Zahi,  Lambert Robert,  Doria Andrea,  Maksymowych Walter,  Van Der Heijde Desiree,  Weiss Pamela,  Sudol-szopinska Iwona,  Herregods Nele,  Jaremko Jacob,  Meyers Arthur

Final Pr. ID: Poster #: EDU-061

Clinical assessment of the Sacroiliac Joint (SIJ) is limited due to the location and anatomy of the joint. Magnetic Resonance Imaging is a sensitive, non- invasive tool in detecting early SIJ inflammatory changes and structural damage in Juvenile Idiopathic Arthritis (JIA). The quantification of interval change of pediatric SIJs using MRI based scoring methods will serve as an important objective outcome measure for the assessment of disease severity and treatment effectiveness in JIA. Read More

Authors:  Otobo Tarimobo , Rumsy Dax , Inarejos Emilio , Kirkhus Eva , Stimec Jennifer , Panwar Jyoti , Thorpe Kevin , Jans Lennart , Van Rossum Marion , Tolend Mirkamal , Perez Manuela , Conaghan Philip , Tzaribachev Nikolay , Sandhya Pulukool , Tse Shirley , Simone Appenzeller , Swami Vimarsha , Touma Zahi , Lambert Robert , Doria Andrea , Maksymowych Walter , Van Der Heijde Desiree , Weiss Pamela , Sudol-szopinska Iwona , Herregods Nele , Jaremko Jacob , Meyers Arthur

Keywords:  Juvenile idiopathic arthritis, OMERACT, outcome measure

Martinez-rios Claudia,  Jariwala Mehul,  Highmore Kerri,  Watanabe Duffy Karen,  Laxer Ronald,  Stimec Jennifer

Final Pr. ID: Poster #: EDU-050

Sterile pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA syndrome) is a rare autosomal dominant inherited entity due to a missense mutation in the proline serine threonine phosphatase-interacting protein 1 (PSTPIP1/CD2BP1) gene, characterized by typical recurrent episodes of sterile pyogenic arthritis, either spontaneous or following a trauma, and skin manifestations characterized by pyoderma gangrenosum and acne. The articular manifestation is seen in the first decade of life, where most of the initial episodes are treated as septic arthritis. Cutaneous manifestations appear in early adulthood. Although uncommon, the potential therapeutic and clinical implications due to the rapidly destructive nature of PAPA syndrome warrant a prompt diagnosis. We present two unrelated pediatric patients from different institutions with genetically confirmed PAPA syndrome. The purpose of this study was to illustrate the musculoskeletal radiologic spectrum of findings of PAPA syndrome, and to discuss the differential diagnostic entities commonly seen in children. A second objective was to review the clinical and laboratory findings that allow diagnosis of PAPA syndrome Read More

Authors:  Martinez-rios Claudia , Jariwala Mehul , Highmore Kerri , Watanabe Duffy Karen , Laxer Ronald , Stimec Jennifer

Keywords:  PAPA, syndrome, arthritis, musculoskeletal, gene-mutation