Dale et al used a classification system to grade radiographic changes in the knees of patients with juvenile rheumatoid arthritis (JRA). This can help to standardize diagnosis and to monitor change over time. The authors are from Oslo Sanitetsforening Rheumatism Hosital in Oslo, Norway.
Patient selection: pediatric or young adult patient with juvenile rheumatoid arthritis
The knee is the most commonly affected joint in JRA during childhood.
Radiographic exam of the knee:
(1) If one knee is affected then bone in the affected joint is compared to bone in the normal contralateral knee.
(2) If both knees are affected then bone of the knees are compared to juxtra-articular bone in the femoral or tibial shafts.
(3) Peri-articular swelling is defined as an increase in density and an anlargement of the supra-patellar pouch by displacement of its fatty lining.
