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

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Tierradentro-garcia Luis, Alizai Hamza

Keywords: Juvenile Idiopathic Arthritis, Multimodality, Rheumatology

Background: Connective tissue disease can affect multiple systems in children. In the central nervous system, these entities can present as cerebrospinal fluid (CSF) disorders, such as CSF leaks, due to dysregulation of collagen and/or other extracellular matrix components. Most patients present with chronic, daily, unremitting headaches that usually improve when lying down. Imaging findings can show classic signs of intracranial hypotension, signs of idiopathic intracranial hypertension, or both. The latter, termed “mixed CSF pressure disorders”, a newer entity described in the literature, can present a diagnostic dilemma as patients can present with atypical symptoms in combination with a clinical history of hypermobility. Conventional CT myelography can confirm capacious thecal sacs, multiple CSF leaks, prominence of perimedullary veins, or multiple dural diverticula. The senior author, a pediatric neurointerventionalist, treated the presented cases. Education goals: 1) To present common heritable (e.g. COL11A2, COL5A2, ADAMTS2, ZNF469, FBN1, FLNA, TNXB) connective tissue diseases that can manifest with CSF disorders in children. 2) To highlight the main findings on conventional CT myelography to detect CSF leaks. 3) To correlate CT myelography findings with brain and spinal MRI in children with CSF disorders. 4) To discuss the options for management from a neurointerventional perspective. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Tierradentro-garcia Luis, Martinez Mesha

Keywords: CSF, Interventional