Joint cartilage thickness and automated determination of bone age and bone health in juvenile idiopathic arthritis

Pediatr Rheumatol Online J. 2017 Aug 10;15(1):63. doi: 10.1186/s12969-017-0194-9.


Background: BoneXpert is an automated method to calculate bone maturation and bone health index (BHI) in children with juvenile idiopathic arthritis (JIA). Cartilage thickness can also be seen as an indicator for bone health and arthritis damage. The objective of this study was to evaluate the relation between cartilage thickness, bone maturation and bone health in patients with JIA.

Methods: Patients with JIA diagnosed according ILAR criteria included in a previous ultrasonography (US) study were eligible if hand radiographs were taken at the same time as the US examination. Of the 95 patients 67 met the inclusion criteria.

Results: Decreased cartilage thickness was seen in 27% of the examined joints. Decreased BHI was seen in half of the JIA patient, and delayed bone maturation was seen in 33% of patients. A combination of decreased BHI and bone age was seen in 1 out of 5 JIA patients. Decreased cartilage thickness in the knee, wrist and MCP joint was negatively correlated with delayed bone maturation but not with bone health index.

Conclusion: Delayed bone maturation and decreased BHI were not related to a thinner cartilage, but a thicker cartilage. No relation with JADAS 10 was found. The rheumatologist should remain aware of delayed bone maturation and BHI in JIA patients with cartilage changes, even in the biologic era.

Keywords: Bone age; Bone health index; Joint cartilage; Juvenile idiopathic arthritis; Musculoskeletal ultrasonography.

MeSH terms

  • Adolescent
  • Age Determination by Skeleton / methods*
  • Arthritis, Juvenile / diagnostic imaging*
  • Bone and Bones / diagnostic imaging*
  • Cartilage / diagnostic imaging*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Ultrasonography / methods