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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,
  3. P Collado4,
  4. M-A D'Agostino5,6,
  5. R Hemke7,
  6. S Jousse-Joulin8,
  7. M Maas7,
  8. A Martini9,10,
  9. E Naredo11,
  10. M Østergaard12,13,
  11. M Rooney14,
  12. N Tzaribachev15,
  13. M A van Rossum16,17,
  14. J Vojinovic18,
  15. P G Conaghan19,
  16. C Malattia9,10
  1. 1NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  2. 2Department of Rheumatology, Yeovil District Hospital, Yeovil, UK
  3. 3MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
  4. 4Hospital Universitario Severo Ochoa, Madrid, Spain
  5. 5Rheumatology Department, APHP, Hôpital Ambroise Paré, Boulogne-Billancourt, France
  6. 6Inserm U1173, Laboratoire d'Excellence INFLAMEX, Université Versailles St. Quentin, Montigny-le-Bretonneux, France
  7. 7Academic Medical Centre Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
  8. 8Brest University Medical School Hospital, Brest, France
  9. 9Institut Gaslini, Genova, Italy
  10. 10Department of Pediatrics, University of Genova, Genova, Italy
  11. 11Rheumatology Department, Hospital General Universitario Gregorio Maraňón, Madrid, Spain
  12. 12Copenhagen Center for Arthritis Research, Center of Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
  13. 13Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
  14. 14Queen's University Belfast, Belfast, UK
  15. 15Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany
  16. 16Academic Medical Centre, Emma Children's Hospital, Amsterdam, The Netherlands
  17. 17Department of Rheumatology, Jan van Breemen Research Institute/Reade, Amsterdam, The Netherlands
  18. 18Faculty of Medicine University of Nis, Department of Pediatric Rheumatology, Clinic Center, Niš, Serbia
  19. 19NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds , Leeds, UK
  1. Correspondence to Dr A N Colebatch-Bourn, Department of Rheumatology, Yeovil District Hospital, Higher Kingston, Yeovil BA21 4AT, UK; alexandra.bourn{at}ydh.nhs.uk

Abstract

To develop evidence based points to consider the use of imaging in the diagnosis and management of juvenile idiopathic arthritis (JIA) in clinical practice. The task force comprised a group of paediatric rheumatologists, rheumatologists experienced in imaging, radiologists, methodologists and patients from nine countries. Eleven questions on imaging in JIA were generated using a process of discussion and consensus. Research evidence was searched systematically for each question using MEDLINE, EMBASE and Cochrane CENTRAL. Imaging modalities included were conventional radiography, ultrasound, MRI, CT, scintigraphy and positron emission tomography. The experts used the evidence obtained from the relevant studies to develop a set of points to consider. The level of agreement with each point to consider was assessed using a numerical rating scale. 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, taking into account the heterogeneity of JIA, the lack of normative data and consequent difficulty identifying pathology. These encompassed 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. Level of agreement for each proposition varied according to the research evidence and expert opinion. Nine points to consider and a related research agenda for the role of imaging in the management of JIA were developed using published evidence and expert opinion.

  • Juvenile Idiopathic Arthritis
  • Ultrasonography
  • Magnetic Resonance Imaging

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