{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T01:07:04Z","timestamp":1788311224732,"version":"build-2803163510"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T00:00:00Z","timestamp":1663632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To define the prevalence of subclinical synovitis on magnetic resonance imaging (MRI) in a large cohort of patients with juvenile idiopathic arthritis (JIA) in clinical remission and to evaluate its predictive value in terms of disease flare and joint deterioration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ninety patients with clinically inactive JIA who underwent a contrast\u2010enhanced (CE)\u2013MRI of a previously affected joint were retrospectively included. Each joint was evaluated for synovitis, tenosynovitis, and bone marrow edema. Baseline and follow\u2010up radiographs were assessed to evaluate structural damage progression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CE\u2010MRI was acquired in 45 wrists, 30 hips, 13 ankles, and 2 knees. Subclinical synovitis was detected in 59 (65.5%) of 90 patients and bone marrow edema in 42 (46.7%) of 90 patients. Fifty\u2010seven of 90 (63.3%) patients experienced a disease flare during follow\u2010up. Forty\u2010four of 59 (74.6%) patients with subclinical synovitis experienced a disease flare versus 13 (41.9%) of 31 patients with no residual synovitis on MRI (<jats:italic>P<\/jats:italic>\u2009=\u20090.002). The presence of subclinical synovitis was the best predictor of disease flare on multivariable regression analysis (hazard ratio [HR] 2.45, <jats:italic>P<\/jats:italic>\u2009=\u20090.003). Baseline and follow\u2010up radiographs were available for 54 patients, and 17 (31.5%) of 54 patients experienced radiographic damage progression. The presence of bone marrow edema (HR 4.40, <jats:italic>P<\/jats:italic>\u2009=\u20090.045) and being &gt;17\u2009years old (HR 3.51, <jats:italic>P<\/jats:italic>\u2009=\u20090.04) were strong predictors of joint damage progression in the multivariable analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MRI\u2010detected subclinical inflammation was present in a large proportion of patients with JIA despite clinical remission. Subclinical synovitis and bone marrow edema have been shown to play a role in predicting the risk of disease relapse and joint deterioration, with potential implications for patients' management of the disease.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.24757","type":"journal-article","created":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T08:32:55Z","timestamp":1626683575000},"page":"198-205","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Predictive Value of Magnetic Resonance Imaging in Patients With Juvenile Idiopathic Arthritis in Clinical Remission"],"prefix":"10.1002","volume":"75","author":[{"given":"Marta","family":"Mazzoni","sequence":"first","affiliation":[{"name":"Universit\u00e0 degli Studi di Genova, Dipartimento di Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno\u2010Infantili  Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Pistorio","sequence":"additional","affiliation":[{"name":"Direzione Scientifica, IRCCS Istituto Giannina Gaslini  Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Magnaguagno","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Giannina Gaslini, UOC di Radiologia, Istituto Giannina Gaslini  Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Viola","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Giannina Gaslini, Clinica Pediatrica e Reumatologia  Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Urru","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Giannina Gaslini, Clinica Pediatrica e Reumatologia  Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Michele","family":"Magnano","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Giannina Gaslini, UOC di Radiologia, Istituto Giannina Gaslini  Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9658-0385","authenticated-orcid":false,"given":"Angelo","family":"Ravelli","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi di Genova, Dipartimento di Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno\u2010Infantili, IRCCS Istituto Giannina Gaslini  Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0521-9488","authenticated-orcid":false,"given":"Clara","family":"Malattia","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi di Genova, Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno\u2010Infantili, Genova, Italy and Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini  Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60363-8"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.080560"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2014.212"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2014-000036"},{"key":"e_1_2_6_6_1","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1136\/annrheumdis-2018-213030","article-title":"Treating juvenile idiopathic arthritis to target: recommendations of an international task force","volume":"77","author":"Ravelli A","year":"2018","journal-title":"Ann Rheum Dis"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20497"},{"key":"e_1_2_6_8_1","first-page":"2290","article-title":"Preliminary criteria for clinical remission for select categories of juvenile idiopathic arthritis","volume":"31","author":"Wallace CA","year":"2004","journal-title":"J Rheumatol"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22190"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23945"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.11481"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-017-4059-7"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21774"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-201264"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211696"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2017.01.003"},{"key":"e_1_2_6_17_1","first-page":"1385","article-title":"OMERACT rheumatoid arthritis magnetic resonance imaging studies. 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