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FRI0503 Eular-Pres Points to Consider for the Use of Imaging in the Diagnosis and Management of Juvenile Idiopathic Arthritis in Clinical Practice
  1. A.N. Colebatch-Bourn1,2,
  2. C.J. Edwards1,3,4,
  3. P. Collado5,
  4. M.A. D'Agostino6,
  5. R. Hemke7,
  6. S. Jousse-Joulin8,
  7. M. Maas7,
  8. A. Martini9,
  9. E. Naredo10,
  10. M. Østergaard11,
  11. M. Rooney12,
  12. N. Tzaribachev13,
  13. M. van Rossum14,
  14. J. Vojinovic15,
  15. P.G. Conaghan16,
  16. C. Malattia17
  1. 1NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton
  2. 2Department of Rheumatology, Yeovil District Hospital, Yeovil
  3. 3Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford
  4. 4MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
  5. 5Hospital Universitario Severo Ochoa, Madrid, Spain
  6. 6Department of Rheumatology, Ambroise Paré Hospital, Boulogne-Billancourt, France
  7. 7Academic Medical Centre Amsterdam, Amsterdam, Netherlands
  8. 8Brest University Medical School Hospital, Brest, France
  9. 9Department of Pediatrics, University of Genoa, Genoa, Italy
  10. 10Department of Rheumatology, Hospital General Universitario Gregorio Maraňόn, Madrid, Spain
  11. 11Copenhagen Center for Arthritis Research, Centre of Rheumatology and Spine Diseases, Copenhagen University Hospital at Glostrup, Copenhagen, Denmark
  12. 12Queen's University Belfast, Belfast, Ireland
  13. 13Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany
  14. 14Academic Medical Centre Amsterdam, Emma Children's Hospital, Amsterdam, Netherlands
  15. 15Clinic of Pediatrics, Department of Pediatric Rheumatology, University Clinic Center, Nis, Serbia
  16. 16Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds & NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, United Kingdom
  17. 17Institut Gaslini, Genova, Italy

Abstract

Objectives To develop evidence based points to consider on the use of imaging in the diagnosis and management of juvenile idiopathic arthritis (JIA) in clinical practice.

Methods The task force comprised an expert group of adult and paediatric rheumatologists, radiologists, and methodologists from 9 countries. Eleven key questions on the role of imaging in JIA were generated using a process of discussion and consensus. Imaging modalities included were conventional radiography (CR), ultrasound (US), magnetic resonance imaging (MRI), computed tomography (CT), scintigraphy and positron emission tomography (PET). Research evidence was searched systematically for each question using MEDLINE, EMBASE and Cochrane CENTRAL. The experts used the evidence obtained from the relevant studies to develop a set of points to consider. The task force assessed their level of agreement with each point to consider using a numerical rating scale. Quality assessment of the included studies was performed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool.

Results A total of 13,277 references were identified from the search process, from which 204 studies were included in the systematic review. Nine points to consider were produced encompassing the role of imaging in making a diagnosis of JIA, detecting and monitoring inflammation and damage, predicting outcome and response to treatment, use of guided therapies, progression and remission (table). The level of evidence, grade of recommendation and level of agreement for each proposition are given in the table, and vary according to both the research evidence and expert opinion.

Conclusions Nine key points to consider for the role of imaging in the management of JIA were developed using research based evidence and expert opinion.

Disclosure of Interest None declared

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