Lambot et al evaluated patients with juvenile idiopathic arthritis for evidence of tenosynovitis in MRI scans of the hand. This can help to diagnose tenosynovitis and to monitor therapy over time. The authors are from Hopital Necker-Enfants Malades in Paris, Great Ormond Street Hospital in London, Ospedale Pediatrico Gaslini in Genoa, and Ospedale Pediatrico Bambino Gesu in Rome/
Patient selection: juvenile idiopathic arthritis
Procedure: MRI scan (3-D T1-W, late post-contrast at 10 minutes, axial plane)
Wrist tendons examined in 4 anatomic areas:
(1) extensors in compartment II (extensors carpia radialis brevis and longus)
(2) extensors in compartment IV (extensors digitorum communis and indicus proprius)
(3) extensors in compartment VI (extensor carpi ulnaris)
(4) flexors in the carpal tunnel
Enhancement
Thickening of Synovial Sheath
Score
absent
none
0
present
mild
1
present
moderate to marked
2
The score is assigned if the changes are seen in >= 1 tenosynovium.
total score =
= SUM(points for all 4 anatomic areas)
Interpretation:
• minimum score: 0
• maximum score: 8
• The higher the score the more severe the tenosynovitis.
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