RESUMO
BACKGROUND: Bony depressions at the wrist resembling erosions are frequently seen on MRI in healthy children. The accuracy of MRI in detecting early bony destruction is therefore questionable. We compared findings on MRI of the wrist in healthy children and those with juvenile idiopathic arthritis (JIA) to investigate markers for true disease. MATERIALS AND METHODS: We compared the number and localisation of bony depressions at the wrist in 85 healthy children and 68 children with JIA, ages 5-15 years. The size of the wrist was assessed from a radiograph of the wrist performed on the same day as the MRI. RESULTS: No significant difference in the number of bony depressions in the carpal bones was seen between healthy children and children with JIA at any age. Depressions are found in similar locations in the two groups, except for a few sites, where bony depressions were seen exclusively in the JIA group, particularly at the CMC joints. The wrist was significantly smaller in children with JIA (P < 0.001). CONCLUSIONS: Using adult scoring systems and standard MR sequences in the assessment of bone destruction in children may lead to overstaging or understaging of disease. At present, standard MRI sequences cannot easily be used for assessment of early signs of erosions in children.
Assuntos
Artrite Juvenil/epidemiologia , Artrite Juvenil/patologia , Imageamento por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Articulação do Punho/anormalidades , Articulação do Punho/patologia , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Noruega/epidemiologia , Prevalência , Estudos Prospectivos , Valores de Referência , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
The scope of the project was to assess the value of using high-resolution, very large displays in a hospital setting. We applied a scenario informed prototyping method and user-involvement in order to do this. Initial results suggest that the technology could prove very useful in clinical conferencing settings like the communicating process between the radiology department and the other hospital departments using their services. The possibility of bringing more visual information simultaneously to the audience is especially intriguing. However, issues such as floor control - who administers the (extra) information space and information-overload, are imminent in interface design and our prototype suggests that the clinicians do want functionality that stresses these issues.
