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Magnetic Resonance Imaging (MRI)

  • Magnetic Resonance Imaging (MRI) is very sensitive to early changes in JIA and can differentiate between bony and soft tissue lesions.
  • MRI is not always available, is expensive and requires sedation or general anaesthesia in younger children.
  • Intravenous contrast, such as gadolinium, is important to the assessment of synovitis. 
  • In the context of inflammatory back pain, MRI of the spine and sacroiliac joints (with gadolinium) is warranted; radiographs are very difficult to interpret in adolescents and the radiation exposure is considerable.

The MRI of the ankle below, shows extensive synovitis with effusion in the ankle and mid-foot (box) in JIA. The MRI was performed with gadolinium with enhancement changes (arrows) consistent with inflammation. 

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