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Updated: May 15, 2026
Erosion Identification in Metacarpophalangeal Joints in Rheumatoid Arthritis using High-Resolution Peripheral Quantitative Computed Tomography
Published on: October 6, 2023
MRI of the wrist in juvenile idiopathic arthritis: erosions or normal variants? A prospective case-control study
Lil-Sofie Ording Muller1, Peter Boavida, Derk Avenarius
1Department of Radiology, University Hospital North Norway, Tromsø, Norway. lil-sofie.ording@unn.no
Background:
Bony depressions at the wrist resembling erosions are frequently seen on MRI in healthy children. The accuracy of MRI in detecting early bony destruction is therefore questionable. We compared findings on MRI of the wrist in healthy children and those with juvenile idiopathic arthritis (JIA) to investigate markers for true disease.
Materials And Methods:
We compared the number and localisation of bony depressions at the wrist in 85 healthy children and 68 children with JIA, ages 5-15 years. The size of the wrist was assessed from a radiograph of the wrist performed on the same day as the MRI.
Results:
No significant difference in the number of bony depressions in the carpal bones was seen between healthy children and children with JIA at any age. Depressions are found in similar locations in the two groups, except for a few sites, where bony depressions were seen exclusively in the JIA group, particularly at the CMC joints. The wrist was significantly smaller in children with JIA (P < 0.001).
Conclusions:
Using adult scoring systems and standard MR sequences in the assessment of bone destruction in children may lead to overstaging or understaging of disease. At present, standard MRI sequences cannot easily be used for assessment of early signs of erosions in children.
Insights
Magnetic resonance imaging (MRI) findings of wrist bony depressions in children with juvenile idiopathic arthritis (JIA) are not distinct from healthy children. Standard MRI sequences are insufficient for assessing early erosions in pediatric JIA.
Area of Science:
- Pediatric Radiology
- Rheumatology
- Medical Imaging
Background:
- Bony depressions on wrist MRI are common in healthy children, questioning MRI's accuracy for early bone destruction.
- Distinguishing true JIA-related bone changes from normal variations is crucial.
Purpose of the Study:
- To compare wrist MRI findings in healthy children and those with juvenile idiopathic arthritis (JIA).
- To identify reliable MRI markers for true disease in pediatric patients.
Main Methods:
- Compared number and location of wrist bony depressions in 85 healthy children and 68 children with JIA (ages 5-15).
- Assessed wrist size using radiographs taken concurrently with MRI.
Main Results:
- No significant difference in the number of carpal bone depressions between healthy children and JIA patients.
- Bony depressions occurred in similar locations, with some exclusive to the JIA group (e.g., CMC joints).
- Children with JIA had significantly smaller wrists.
Conclusions:
- Standard MRI sequences and adult scoring systems may misdiagnose bone destruction in pediatric JIA.
- Current standard MRI protocols are inadequate for assessing early erosions in children with JIA.
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