Juvenile idiopathic arthritis with dry synovitis: clinical and imaging aspects in a cohort of 6 patients

Results The cohort included 2 boys and 4 girls, median (range) age was 9.7yr(3-15). The median (range) age at first manifestation and diagnosis were respectively 4.5yr(1.38.9) and 8.3yr(3-14). Presenting signs comprised delayed motor development and/or progressive articular stiffness. Little or no pain was mentioned. Clinical examination showed a symmetric and polyarticular involvement without obvious clinical signs of synovitis. CRP was normal and ESR<35mm/h. In 5/6 patients ANA was absent. Radiological imaging (wrist and/or pelvis) comprised osteopenia, advanced bone age, irregular bone contours and/or erosions in all patients. MRI revealed synovial thickening in 5/6 patients; bone edema was variably present and bone erosions were demonstrated in 4/6 patients. Treatments comprised NSAIDs(n=5/6), corticosteroids(n=3/6), methotrexate(n=5/6), anti-TNF(n=5/ 6) and resulted in subjective improvement. However articular limitations persisted and imaging showed progressive articular damage.