Whole-body MRI in paediatric undefined inflammatory conditions.

Abstract

BACKGROUND\nWhole Body Magnetic Resonance Imaging (WBMRI) is a multiregional imaging technique suitable to investigate the extent of multisystemic diseases without exposure to radiation, with a high sensitivity to bone alterations. The aim of our study was to evaluate the role of WBMRI in the workup of children with non-specific musculoskeletal features, and non-indicative laboratory and instrumental data, suspected to have a rheumatologic disease.\n\n\nMETHODS\nWe retrospectively analysed medical records, including laboratory tests and radiological data of 34 children who have been evaluated due to non-specific musculoskeletal manifestations, for which a WBMRI was prescribed.\n\n\nRESULTS\nWe included 34 children, 19 females and 15 males, mean age 10 years (range 2-16 years), with the following clinical features: diffuse arthralgia (12 children), persistent fever (2 children), persistent fever and diffuse arthralgia (20 children). Serologic inflammatory markers resulted increased in 29/34 patients. Twenty-five children had already performed X-Ray and/or ultrasound before WBMRI, with a negative/uninformative result. WBMRI was performed 3-6 weeks (median, 3.5 weeks) after the initial presentation of symptoms. In 22/34 (65%) children WBMRI revealed some abnormalities that supported the final diagnosis. Twelve out of 34 children (34%) resulted to be affected by chronic recurrent multifocal osteomyelitis (CRMO).\n\n\nCONCLUSIONS\nWBMRI is helpful in paediatric rheumatology in the differential diagnosis of undefined inflammatory conditions. It appears to be a promising tool especially in the detection of multifocal bone lesions. The diagnosis that mainly benefits from WBMRI was CRMO. WBMRI can also help in excluding neoplastic diseases.