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Picture-perfect: imaging techniques in juvenile idiopathic arthritis

Norah J Shire and Bernard J Dardzinski

Juvenile idiopathic arthritis is a debilitating condition consisting of several categories of arthritis. Early detection, accurate diagnosis and monitoring of changes upon treatment are critical in order to minimize long-term sequelae. Imaging modalities, such as radiography, ultrasound and MRI are commonly employed to evaluate synovial inflammation, joint effusion, bone erosions and other disease manifestations. Challenges in pediatric populations arise from lack of technology appropriate for small joint imaging and the lack of available data for standardization and validation of imaging methods and disease grading. This review describes the optimal utility and advantages and disadvantages of various imaging methods, focusing on an in-depth review of current and novel MRI techniques and suggesting protocols for implementation.