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Detection of inflammation by whole-body MRI in young people with juvenile idiopathic arthritis (JIA)

Choida, Vera; Bray, T; Van Vucht, N; Abbasi, AM; Bainbridge, A; Parry, T; Mallet, Sue; ... Hall-Craggs, Margaret; + view all (2024) Detection of inflammation by whole-body MRI in young people with juvenile idiopathic arthritis (JIA). Rheumatology , Article keae039. 10.1093/rheumatology/keae039. (In press). Green open access

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Abstract

OBJECTIVES: To assess the frequency of joint inflammation detected by whole-body MRI (WBMRI) in young people (YP) with JIA and controls, and to determine the relationship between WBMRI-detected inflammation and clinical findings. METHODS: YP aged 14–24 years, with JIA (patients) or arthralgia without JIA (controls), recruited from one centre, underwent a WBMRI scan after formal clinical assessment. Consensus between at least two of the three independent radiologists was required to define inflammation and damage on WBMRI, according to predefined criteria. YP with JIA were deemed clinically active as per accepted definitions. The proportions of YP with positive WBMRI scans for joint inflammation (≥1 inflamed joint) as well as serum biomarkers were compared between active vs inactive JIA patients and controls. RESULTS: Forty-seven YP with JIA (25 active and 22 inactive patients) and 13 controls were included. WBMRI detected joint inflammation in 60% (28/47) patients with JIA vs 15% (2/13) controls (difference: 44%, 95% CI 20%, 68%). More active than inactive JIA patients had WBMRI-detected inflammation [76% (19/25) vs 41% (9/22), difference: 35% (95% CI 9%, 62%)], and this was associated with a specific biomarker signature. WBMRI identified inflammation in ≥ 1 clinically inactive joint in 23/47 (49%) patients (14/25 active vs 9/22 inactive JIA patients). CONCLUSIONS: WBMRI’s validity in joint assessment was demonstrated by the higher frequency of inflammation in JIA patients vs controls, and in active vs inactive JIA patients. WBMRI found unsuspected joint inflammation in 49% YP with JIA, which needs further investigation of potential clinical implications.

Type: Article
Title: Detection of inflammation by whole-body MRI in young people with juvenile idiopathic arthritis (JIA)
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/rheumatology/keae039
Publisher version: https://doi.org/10.1093/rheumatology/keae039
Language: English
Additional information: © The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Whole-body, MRI, JIA, synovitis, outcomes, disease activity, MMP-3, VEGF
URI: https://discovery.ucl.ac.uk/id/eprint/10185933
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