Consider the wrist: a retrospective study on pediatric connective tissue disease with MRI

Charlotte M. Nusman, J. Merlijn van den Berg, Amara Nassar-Sheikh Rashid, Katerina Ntailiani, Apostolos Karantanas, Taco W. Kuijpers, Mario Maas, Dieneke Schonenberg-Meinema

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

The aim of this study is to describe the clinical characteristics and MRI findings of the wrist in a cohort of children suffering from connective tissue disease with musculoskeletal involvement. Ten patients with pediatric connective tissue disease [median age 14.7 years (IQR 12.7–16.6 years), 70% female] were identified from a large MRI database. Clinical findings during the disease course were retrospectively obtained from patient charts and findings at the time of MRI were prospectively registered in the MRI database. MRI wrist datasets were evaluated by three readers in consensus for synovitis, tenosynovitis, bone marrow changes, bone erosions and myositis. Patients suffered from connective tissue disease with clinical overlap of subtypes systemic lupus erythematosus, Sjögren syndrome and dermatomyositis. Median onset of disease was at 12.3 years (IQR 7.8–14.8 years). Clinical arthritis activity was scored low (median visual analogue scale physician 19, IQR 7–31). Notwithstanding, extensive inflammatory abnormalities such as synovitis and tenosynovitis were found in the wrist of 7/10 patients. Osteochondral involvement was detected in 3/10 patients. In a small cohort of children with connective tissue disease and musculoskeletal symptoms, severe inflammatory abnormalities of the involved wrist were present in the MRI, while clinical disease scores suggested mild disease activity. Therefore, clinicians should consider the wrist as vulnerable for joint damage and can add MRI as a helpful tool in the management of patients with pediatric connective tissue disease and musculoskeletal involvement.
Original languageEnglish
JournalRheumatology International
DOIs
Publication statusPublished - 2019

Cite this

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title = "Consider the wrist: a retrospective study on pediatric connective tissue disease with MRI",
abstract = "The aim of this study is to describe the clinical characteristics and MRI findings of the wrist in a cohort of children suffering from connective tissue disease with musculoskeletal involvement. Ten patients with pediatric connective tissue disease [median age 14.7 years (IQR 12.7–16.6 years), 70{\%} female] were identified from a large MRI database. Clinical findings during the disease course were retrospectively obtained from patient charts and findings at the time of MRI were prospectively registered in the MRI database. MRI wrist datasets were evaluated by three readers in consensus for synovitis, tenosynovitis, bone marrow changes, bone erosions and myositis. Patients suffered from connective tissue disease with clinical overlap of subtypes systemic lupus erythematosus, Sj{\"o}gren syndrome and dermatomyositis. Median onset of disease was at 12.3 years (IQR 7.8–14.8 years). Clinical arthritis activity was scored low (median visual analogue scale physician 19, IQR 7–31). Notwithstanding, extensive inflammatory abnormalities such as synovitis and tenosynovitis were found in the wrist of 7/10 patients. Osteochondral involvement was detected in 3/10 patients. In a small cohort of children with connective tissue disease and musculoskeletal symptoms, severe inflammatory abnormalities of the involved wrist were present in the MRI, while clinical disease scores suggested mild disease activity. Therefore, clinicians should consider the wrist as vulnerable for joint damage and can add MRI as a helpful tool in the management of patients with pediatric connective tissue disease and musculoskeletal involvement.",
author = "Nusman, {Charlotte M.} and {van den Berg}, {J. Merlijn} and {Nassar-Sheikh Rashid}, Amara and Katerina Ntailiani and Apostolos Karantanas and Kuijpers, {Taco W.} and Mario Maas and Dieneke Schonenberg-Meinema",
year = "2019",
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Consider the wrist: a retrospective study on pediatric connective tissue disease with MRI. / Nusman, Charlotte M.; van den Berg, J. Merlijn; Nassar-Sheikh Rashid, Amara; Ntailiani, Katerina; Karantanas, Apostolos; Kuijpers, Taco W.; Maas, Mario; Schonenberg-Meinema, Dieneke.

In: Rheumatology International, 2019.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Consider the wrist: a retrospective study on pediatric connective tissue disease with MRI

AU - Nusman, Charlotte M.

AU - van den Berg, J. Merlijn

AU - Nassar-Sheikh Rashid, Amara

AU - Ntailiani, Katerina

AU - Karantanas, Apostolos

AU - Kuijpers, Taco W.

AU - Maas, Mario

AU - Schonenberg-Meinema, Dieneke

PY - 2019

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N2 - The aim of this study is to describe the clinical characteristics and MRI findings of the wrist in a cohort of children suffering from connective tissue disease with musculoskeletal involvement. Ten patients with pediatric connective tissue disease [median age 14.7 years (IQR 12.7–16.6 years), 70% female] were identified from a large MRI database. Clinical findings during the disease course were retrospectively obtained from patient charts and findings at the time of MRI were prospectively registered in the MRI database. MRI wrist datasets were evaluated by three readers in consensus for synovitis, tenosynovitis, bone marrow changes, bone erosions and myositis. Patients suffered from connective tissue disease with clinical overlap of subtypes systemic lupus erythematosus, Sjögren syndrome and dermatomyositis. Median onset of disease was at 12.3 years (IQR 7.8–14.8 years). Clinical arthritis activity was scored low (median visual analogue scale physician 19, IQR 7–31). Notwithstanding, extensive inflammatory abnormalities such as synovitis and tenosynovitis were found in the wrist of 7/10 patients. Osteochondral involvement was detected in 3/10 patients. In a small cohort of children with connective tissue disease and musculoskeletal symptoms, severe inflammatory abnormalities of the involved wrist were present in the MRI, while clinical disease scores suggested mild disease activity. Therefore, clinicians should consider the wrist as vulnerable for joint damage and can add MRI as a helpful tool in the management of patients with pediatric connective tissue disease and musculoskeletal involvement.

AB - The aim of this study is to describe the clinical characteristics and MRI findings of the wrist in a cohort of children suffering from connective tissue disease with musculoskeletal involvement. Ten patients with pediatric connective tissue disease [median age 14.7 years (IQR 12.7–16.6 years), 70% female] were identified from a large MRI database. Clinical findings during the disease course were retrospectively obtained from patient charts and findings at the time of MRI were prospectively registered in the MRI database. MRI wrist datasets were evaluated by three readers in consensus for synovitis, tenosynovitis, bone marrow changes, bone erosions and myositis. Patients suffered from connective tissue disease with clinical overlap of subtypes systemic lupus erythematosus, Sjögren syndrome and dermatomyositis. Median onset of disease was at 12.3 years (IQR 7.8–14.8 years). Clinical arthritis activity was scored low (median visual analogue scale physician 19, IQR 7–31). Notwithstanding, extensive inflammatory abnormalities such as synovitis and tenosynovitis were found in the wrist of 7/10 patients. Osteochondral involvement was detected in 3/10 patients. In a small cohort of children with connective tissue disease and musculoskeletal symptoms, severe inflammatory abnormalities of the involved wrist were present in the MRI, while clinical disease scores suggested mild disease activity. Therefore, clinicians should consider the wrist as vulnerable for joint damage and can add MRI as a helpful tool in the management of patients with pediatric connective tissue disease and musculoskeletal involvement.

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