Knee in Early Juvenile Rheumatoid Arthritis: MR Imaging Findings

September 5, 2001

(Radiology. 2001;220:696-706.) © RSNA, 2001

M. Gylys-Morin, MD, T. Brent Graham, MD, Judy S. Blebea, MD,

Bernard J. Dardzinski, PhD, Tal Laor, MD, Neil D. , MD, Alan E.

Oestreich, MD and Murray H. Passo, MD

1 From the Departments of Radiology (V.M.G.M., B.J.D., T.L., N.D.J.,

A.E.O.) and Rheumatology (T.B.G., M.H.P.), Children’s Hospital Medical

Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039; and the Department

of Radiology, Milton Hershey Medical Center, Hershey, Pa (J.S.B.).

PURPOSE: To determine the magnetic resonance (MR) imaging findings in

the knee in early juvenile rheumatoid arthritis.

MATERIALS AND METHODS: MR imaging (1.5 T) was performed in the more

symptomatic knee in 30 children with juvenile rheumatoid arthritis with

a

symptom duration 1 year or less. Conventional, fast spin-echo,

three-dimensional gradient-echo, and gadolinium-enhanced T1-weighted

images were assessed. Two radiologists independently read the images,

and a third resolved disagreements. These images were compared with knee

radiographs in 27 children.

RESULTS: Mean maximal synovial thickness was 4.8 mm ± 2.4 (SD). Mean

synovial volume was 15.4 mL ± 10.8. Suprapatellar joint effusions were

seen in 26 (87%) of 30 knees, meniscal hypoplasia in 11 (37%) of 30

knees, and abnormal epiphyseal marrow in eight (27%) of 30 knees. Three

knees had articular cartilage contour irregularity, fissures, and/or

thinning. One knee had a bone erosion. Knee radiographs showed

suprapatellar fullness in 78% of the knees, joint space narrowing in one

knee, and no bone abnormalities.

CONCLUSION: Synovial hypertrophy and joint effusions are the most

frequent MR imaging findings of knees in early juvenile rheumatoid

arthritis. Early in the disease, radiographically occult cartilage and

bone erosions are uncommonly seen at MR imaging. The potential

relationship of synovitis to cartilage abnormalities deserves further

study.

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