#Radiography is the initial imaging method used in #childhood #arthritis. However, radiographic findings of juvenile idiopathic arthritis (JIA) differ according to disease duration, patients’ age, and type of affected joint. Early changes of JIA, including soft tissue swelling, joint effusion, periostitis, and periarticular osteopenia can be observed. These findings can be more accurately delineated when compared with the unaffected contralateral extremity. Late radiographic changes consist of joint space narrowing, erosions, subchondral cysts, ankylosis, growth disturbances, periarticular calcifications, and diffuse osteoporosis.

The use of radiography as a screening test for synovitis and enthesitis is strongly recommended against by the imaging recommendations of the 2021 ACR Guideline mainly related to its low sensitivity and specificity, with several JIA radiographic mimickers such as traumatic joint pathologies, infections, malignancies, hemophilic arthropathy, and metabolic disorders. However, in JIA, radiography still holds particular importance in the assessment of osteochondral changes and growth disturbances.

*Avar-Aydin PO, Ting TV, Vega-Fernandez P. Imaging in Juvenile Idiopathic Arthritis. Rheum Dis Clin North Am. 2024;50(4):623-640. 
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