EFFECTS OF METHOTREXATE ON RADIOLOGIC PROGRESSION IN JUVENILE RHEUMATOID-ARTHRITIS

Objective. To assess the effects of methotrexate (MTX) therapy on radi ologic progression in juvenile rheumatoid arthritis (JRA). Methods. We evaluated serial wrist radiographs for carpal length in 23 JRA patien ts with bilateral wrist involvement, before and during MTX treatment. These carpal length measurements were compared with established norms for carpal length in a healthy pediatric population. Results. Both cli nical responders to MTX (17 of 23 patients) and nonresponders (6 of 23 ) had decreasing carpal length prior to initiation of the treatment. E leven of the 17 clinical responders had improved carpal length after a mean of 2.5 years of MTX treatment. All 6 clinical nonresponders had progressive loss of carpal length. Conclusion. MTX treatment resulted in radiologic improvement, as measured by carpal length, in the majori ty of children with JRA who had a clinical response to MTX.