JUVENILE RHEUMATOID-ARTHRITIS - CERVICAL-SPINE INVOLVEMENT AND MRI INEARLY DIAGNOSIS

Magnetic resonance imaging (MRI) of the cervical spine was performed o n 20 patients (mean age 10 years) with a preliminary diagnosis of juve nile rheumatoid arthritis (JRA). In all patients conventional x-rays o f the cervical spine were obtained, and the relationship between clini cal status and MRI findings were evaluated. Two patients with clinical manifestations, including neck pain and diminished range of motion, e xhibited significant pathologic features on radiogram and MRI, the lat ter providing more detailed information. Among 18 patients who had no complaints about their cervical spines, 3 patients (65%) had either so ft tissue involvement, pannus formation or erosions on the surface of atlantoaxial joints; only four patients (20%) had erosions on plain x- ray views. Since the early diagnostic ability of MRI in JRA allows ear ly therapeutic intervention, every patient with a probable diagnosis o f JRA would benefit from MRI.