Skip to main content
Top
Published in: Pediatric Rheumatology 1/2013

Open Access 01-12-2013 | Short Report

Osteochondral lesions in children with juvenile idiopathic arthritis

Authors: Liisa Kröger, Eija Piippo-Savolainen, Erja Tyrväinen, Pekko Penttilä, Heikki Kröger

Published in: Pediatric Rheumatology | Issue 1/2013

Login to get access

Abstract

Background

Joint pain and swelling are typical symptoms in children with juvenile idiopathic arthritis (JIA) and these are often related to inflammation of the joint. Juvenile osteochondritis dissecans (JOCD), that is separation of a bone-cartilage segment from the articular surface, can manifest with similar symptoms.

Findings

We studied thirteen cases of osteochondritis dissecans lesions (OCD) in children with JIA. There were nine girls and four boys with a mean age of 6.5 (2–12) years at the time of diagnosis of JIA. Mean time between diagnosis of JIA and manifestation of OCD was 5.5 (1–11) years. Indications for MRI were the presence of pain or discomfort in the joint, despite otherwise effective treatment, with no evidence from ultrasound examination of any obvious signs of active inflammation. The most common location of osteochondral lesion was the knee, although the ankle joint was affected in one case. Five patients had lesions in both knees. Operative treatment was needed in eight cases (joints).

Conclusions

Pain, and minor dysfunction of the joint are common complaints of children suffering from JIA. Earlier research has discounted the possibility of children who were not athletes presenting with this condition. However, this study demonstrates that these lesions also seem to be relatively common in patients with JIA. When there is no sign of inflammation, the possibility of OCD must therefore be considered in these children.
Appendix
Available only for authorised users
Literature
1.
go back to reference Cahill BR: Current concept review. Osteochondritis dissecans. J Bone Joint Surg. 1997, 79: 471-472.PubMed Cahill BR: Current concept review. Osteochondritis dissecans. J Bone Joint Surg. 1997, 79: 471-472.PubMed
2.
go back to reference Kocher MS, Tucker R, Ganley TJ, Flynn JM: Management of osteochondritis dissecans of the knee: current concepts review. Am J Sport Med. 2006, 34: 181-191. 10.1177/0363546505285257.CrossRef Kocher MS, Tucker R, Ganley TJ, Flynn JM: Management of osteochondritis dissecans of the knee: current concepts review. Am J Sport Med. 2006, 34: 181-191. 10.1177/0363546505285257.CrossRef
3.
go back to reference Robertson W, Kelly BT, Green DW: Osteochondritis dissecans of the knee in children. Curr Opin Pediatr. 2003, 15: 38-44. 10.1097/00008480-200302000-00007.CrossRefPubMed Robertson W, Kelly BT, Green DW: Osteochondritis dissecans of the knee in children. Curr Opin Pediatr. 2003, 15: 38-44. 10.1097/00008480-200302000-00007.CrossRefPubMed
4.
go back to reference Prakken B, Albani S, Martini A: Juvenile idiopathic arthritis. Lancet. 2011, 377: 2138-2149. 10.1016/S0140-6736(11)60244-4.CrossRefPubMed Prakken B, Albani S, Martini A: Juvenile idiopathic arthritis. Lancet. 2011, 377: 2138-2149. 10.1016/S0140-6736(11)60244-4.CrossRefPubMed
5.
go back to reference Damasio B, Malattia C, Martini A, Toma P: Synovial and inflammatory diseases in childhood: role of new imaging modalities in the assessment of patients with juvenile idiopathic arthritis. Pediatr Radiol. 2010, 40: 985-998. 10.1007/s00247-010-1612-z.CrossRefPubMed Damasio B, Malattia C, Martini A, Toma P: Synovial and inflammatory diseases in childhood: role of new imaging modalities in the assessment of patients with juvenile idiopathic arthritis. Pediatr Radiol. 2010, 40: 985-998. 10.1007/s00247-010-1612-z.CrossRefPubMed
6.
go back to reference Obedian RS, Grelsamer RP: Osteochondritis dissecans of the distal femur and patella. Clin Sport Med. 1997, 16: 157-175. 10.1016/S0278-5919(05)70012-0.CrossRef Obedian RS, Grelsamer RP: Osteochondritis dissecans of the distal femur and patella. Clin Sport Med. 1997, 16: 157-175. 10.1016/S0278-5919(05)70012-0.CrossRef
7.
go back to reference Stougaard J: Familial occurrence of osteochondritis dissecans. J Bone Joint Surg. 1964, 46: 542-3. Stougaard J: Familial occurrence of osteochondritis dissecans. J Bone Joint Surg. 1964, 46: 542-3.
8.
go back to reference Mubarak SJ, Carroll NC: Familial osteochondritis dissecans of the knee. Clin Orthop Relat Res. 1979, 140: 131-6.PubMed Mubarak SJ, Carroll NC: Familial osteochondritis dissecans of the knee. Clin Orthop Relat Res. 1979, 140: 131-6.PubMed
9.
go back to reference Beresford MW, Baildam EM: New advances in the management of juvenile idiopathic arthritis – 1: Non-biologic therapy. Arch Dis Child. 2009, 94: 144-150. 10.1136/adc.2008.139865.CrossRef Beresford MW, Baildam EM: New advances in the management of juvenile idiopathic arthritis – 1: Non-biologic therapy. Arch Dis Child. 2009, 94: 144-150. 10.1136/adc.2008.139865.CrossRef
10.
go back to reference Habib GS, Saliba W: Nashashibi: M. Local effects of intra-articular corticosteroids. Clin Rheumatol. 2010, 29: 347-356. 10.1007/s10067-009-1357-y.CrossRefPubMed Habib GS, Saliba W: Nashashibi: M. Local effects of intra-articular corticosteroids. Clin Rheumatol. 2010, 29: 347-356. 10.1007/s10067-009-1357-y.CrossRefPubMed
11.
go back to reference Boutin RD, Januario JA, Newberg AH, Gundry CR, Newman JS: MR imaging features of osteochondritis dissecans of the femoral sulcus. Am J Roentgenol. 2003, 180: 641-645. 10.2214/ajr.180.3.1800641.CrossRef Boutin RD, Januario JA, Newberg AH, Gundry CR, Newman JS: MR imaging features of osteochondritis dissecans of the femoral sulcus. Am J Roentgenol. 2003, 180: 641-645. 10.2214/ajr.180.3.1800641.CrossRef
12.
go back to reference Quatman CE, Qatman-Yates CC, Schmitt LC, Paterno MV: The clinical utility and diagnostic performance of MRI for identification and classification of knee osteochondritis dissecans. J Bone Joint Surg Am. 2012, 94: 1036-1044.PubMedCentralCrossRefPubMed Quatman CE, Qatman-Yates CC, Schmitt LC, Paterno MV: The clinical utility and diagnostic performance of MRI for identification and classification of knee osteochondritis dissecans. J Bone Joint Surg Am. 2012, 94: 1036-1044.PubMedCentralCrossRefPubMed
13.
go back to reference Wall EJ, Vourazeris J, Myer GD, Emery KH, Divine JG, Nick TG, Hewett TE: The healing potential of stable juvenile osteochondritis dissecans knee lesions. J Bone Joint Surgery. 2008, 90: 2655-2664. 10.2106/JBJS.G.01103. Wall EJ, Vourazeris J, Myer GD, Emery KH, Divine JG, Nick TG, Hewett TE: The healing potential of stable juvenile osteochondritis dissecans knee lesions. J Bone Joint Surgery. 2008, 90: 2655-2664. 10.2106/JBJS.G.01103.
14.
go back to reference Kon E, Vannini F, Buda R: How to treat osteochondritis dissecans of the knee: Surgical technique and new trends. J Bone Joint Surg Am. 2012, 94: 1-8.CrossRef Kon E, Vannini F, Buda R: How to treat osteochondritis dissecans of the knee: Surgical technique and new trends. J Bone Joint Surg Am. 2012, 94: 1-8.CrossRef
Metadata
Title
Osteochondral lesions in children with juvenile idiopathic arthritis
Authors
Liisa Kröger
Eija Piippo-Savolainen
Erja Tyrväinen
Pekko Penttilä
Heikki Kröger
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Pediatric Rheumatology / Issue 1/2013
Electronic ISSN: 1546-0096
DOI
https://doi.org/10.1186/1546-0096-11-18

Other articles of this Issue 1/2013

Pediatric Rheumatology 1/2013 Go to the issue