Correlation analysis of MRI features and clinical indexes in juvenile idiopathic arthritis

FENG Hexin; PAN Shinong; LI Pengfei

doi:10.19300/j.2024.L21490

Abstract：Objective To explore the differences in MRI features among different clinical subtypes of children with juvenile idiopathic arthritis(JIA)and to analyze the correlation between MRI features and clinical scores.Methods MRI images and clinical data from 55 children with JIA,aged 1-14 years(mean age 8.1±4.1 years),were retrospectively collected.The children were divided into four clinical subtypes:systemic(12 cases),polyarthritic(17 cases),oligoarthritic(16 cases),and enthesities-related arthritis(ERA)(10 cases).MRI features,such as synovial hyperplasia and bone marrow edema in both large and small joints,were observed,and bone marrow edema and synovial hyperplasia were scored.One-way ANOVA,Welch test or Chi-square test were used to compare clinical data and imaging features among the four groups.Pearson test or Spearman test was used to evaluate the correlation between imaging features and clinical scores.Results Among the 55 children,35 had synovial hyperplasia and 33 had bone marrow edema.There were significant differences in erythrocyte sedimentation rate(ESR),HLA-B27,and foot/ankle involvement among the four subtypes(P＜0.05).The oligoarthritic subtype had a significantly higher proportion of foot/ankle involvement compared to the systemic and ERA subtypes(all P＜0.05),while other clinical subtypes did not show specific joint involvement.The incidence of synovial hyperplasia was higher in polyarthritic and oligoarthritic patients,while bone marrow edema was more common in the ERA patients.The systemic patients mostly showed only joint effusion(all P＜0.05).Comparison of joint scores among the four subtypes revealed that ERA patients had higher bone marrow edema scores in large joints,while polyarthritic and oligoarthritic patients had higher scores for small joints(all P＜0.05).However,there was no significant difference in synovial hyperplasia scores(all P＞0.05).In large joint,the scores of bone marrow edema were positively correlated with ESR,C-reaction protein(CRP),and age,and the scores of synovial hyperplasia were positively correlated with age and symptom duration(all P＜0.05).In small joints,bone marrow edema scores were positively correlated with ESR and CRP(all P＜0.05).Conclusion The affected joints and MR1 features in JIA patients vary between clinical subtypes,and the severity of joint lesions is highly correlated with clinical indexes.