{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:27:37Z","timestamp":1780471657313,"version":"3.54.1"},"reference-count":15,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,10,1]]},"abstract":"<jats:p>Etiologies for childhood-onset diffuse joint contractures encompass a large group of inherited disorders and acquired diseases, in particular a subtype of juvenile idiopathic arthritis called \u201cdry polyarthritis,\u201d dermatomyositis, and systemic sclerosis. We report on 2 boys, aged 5 and 8 years, who developed acquired symmetric painless joint contractures preceding the development of superficial plaques of morphea by 7 to 13 months. There was no other clinical involvement, biological inflammation, or autoantibodies. No urinary mucopolysaccharidosis was seen. In both patients, wrist MRI showed no joint effusion, no bone erosion, and no or mild synovial thickening with slight enhancement after gadolinium infusion. One patient underwent a synovial biopsy, which showed dense fibrosis with a sparse inflammatory infiltrate, similar to the pathologic pattern observed in the skin biopsy. With methotrexate and systemic steroids, joint contractures slowly improved in the first patient and remained stable in the second. These 2 cases suggest that fibrous synovitis should be considered in children with acquired diffuse, symmetric, painless contractures and without elevation of acute-phase reactants, even in the absence of cutaneous manifestations. Articular MRI with gadolinium and careful cutaneous examination at onset and during follow-up should provide clues for diagnosing this entity.<\/jats:p>","DOI":"10.1542\/peds.2016-1899","type":"journal-article","created":{"date-parts":[[2017,9,27]],"date-time":"2017-09-27T09:10:19Z","timestamp":1506503419000},"source":"Crossref","is-referenced-by-count":9,"title":["Fibrous Arthropathy Associated With Morphea: A New Cause of Diffuse Acquired Joint Contractures"],"prefix":"10.1542","volume":"140","author":[{"given":"Etienne","family":"Merlin","sequence":"first","affiliation":[{"name":"Inserm CIC 1405, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Breton","sequence":"additional","affiliation":[{"name":"Radiologie P\u00e9diatrique, H\u00f4pital Necker Enfants Malades, Assistance Publique \u2013 Hopitaux de Paris, Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Fraitag","sequence":"additional","affiliation":[{"name":"Service d\u2019Anatomie et de Cytologie Pathologiques, H\u00f4pital Necker Enfants Malades, Assistance Publique \u2013 Hopitaux de Paris, Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Louis","family":"St\u00e9phan","sequence":"additional","affiliation":[{"name":"Service d\u2019h\u00e9matologie immunologie et rhumatologie p\u00e9diatrique, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Priest-en-Jarez, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carine","family":"Wouters","sequence":"additional","affiliation":[{"name":"Department of Pediatric Rheumatology, University Hospital Leuven, Leuven, Belgium;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Bodemer","sequence":"additional","affiliation":[{"name":"Service de Dermatologie, H\u00f4pital Necker Enfants Malades, Institut IMAGINE, Assistance Publique \u2013 Hopitaux de Paris, Paris, France; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Bader-Meunier","sequence":"additional","affiliation":[{"name":"Unit\u00e9 d\u2019Immuno-H\u00e9matologie et Rhumatologie P\u00e9diatrique, H\u00f4pital Necker Enfants Malades, Institut IMAGINE, Assistance Publique \u2013 Hopitaux de Paris, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2017,10,1]]},"reference":[{"issue":"2","key":"2021121102490555600_B1","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.pcl.2012.03.011","article-title":"Pediatric scleroderma: systemic or localized forms.","volume":"59","author":"Torok","year":"2012","journal-title":"Pediatr Clin North Am"},{"issue":"2","key":"2021121102490555600_B2","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.jaad.2010.05.045","article-title":"Update on morphea: part I. 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