The Thoracic and Lumbar Spine in Severe Juvenile Idiopathic Arthritis: Magnetic Resonance Imaging Analysis in 50 Children

• Published in: The Journal of pediatrics 2012, Vol.160 (1), p.140-146
• Main Authors: Toiviainen-Salo, Sanna, MD, PhD, Markula-Patjas, Kati, MD, Kerttula, Liisa, MD, PhD, Soini, Irma, MD, PhD, Valta, Helena, MD, PhD, Mäkitie, Outi, MD, PhD
• Format: Article
• Language: English
• Subjects: Adolescent; arthritis; Arthritis, Juvenile - complications; Biological and medical sciences; bone density; Child; children; Cross-Sectional Studies; Diseases of the osteoarticular system; Female; General aspects; Humans; Inflammatory joint diseases; lumbar spine; Lumbar Vertebrae - injuries; Magnetic Resonance Imaging; Male; Medical sciences; Medicin och hälsovetenskap; muscles; muscular atrophy; pain; patients; Pediatrics; Prevalence; Severity of Illness Index; Spinal Fractures - diagnosis; Spinal Fractures - epidemiology; Spinal Fractures - etiology; Thoracic Vertebrae - injuries
• ISSN: 0022-3476; 1097-6833; 1097-6833
• DOI: 10.1016/j.jpeds.2011.06.030

Objective To determine the prevalence of vertebral fractures as a complication of juvenile idiopathic arthritis (JIA). Study design This cross-sectional study evaluated the prevalence and characteristics of spinal abnormalities in 50 children (aged 7.0-18.7 years) with treatment-resistant JIA by magnetic resonance imaging. Vertebral deformities, endplate irregularities, intervertebral disc involvement, spinal canal, neural foramina, and back muscles were analyzed and correlated with clinical characteristics and bone mineral density. Results Magnetic resonance imaging revealed various abnormalities in 31 patients (62%). Vertebral compression was seen in 28%, disc degeneration in 46%, protrusions in 14%, prolapses in 4%, endplate changes in 26%, and anterior vertebral corner lesions in 16%. Two patients (4%) had mild spinal canal narrowing without medullar involvement; none had neural root compression. Six patients (12%) had mild back muscle atrophy. No correlation was observed between spinal fractures or other vertebral changes and disease activity or duration, pain or bone mineral density; patients with spinal fractures tended to have a higher recent glucocorticoid exposure ( P = .086). Conclusion Children with severe JIA have a high prevalence of compression fractures and other vertebral, endplate, and disc abnormalities in the thoracic and lumbar spine.