Uncommon radiological features of chronic arthritis in childhood: a review

Radiological changes depend on the age of onset as well as the pattern of disease present (Ansell & Kent 1977). Seronegative disease tends to be associated with modelling abnormalities of the epiphyses, loss of joint space and the late development of erosions, although an occasional polyarthritis following systemic disease has a very destructive arthritis and overall failure of growth. Pauciarticular disease is associated with growth anomalies of epiphyses and also metaphyses in asymmetrical fashion. In spondylitic children, enthesiopathies are marked and there is a high incidence of hip involvement. Seropositive juvenile rheumatoid arthritis shows a severe erosive arthropathy early, combined with minor growth changes, particularly bony overgrowth in the hands and feet in the early teens. The hallmark of the psoriatic is the asymmetry and, in a few cases, the destructive nature of asymmetrically involved joints.