Table 2.

Conventional radiography in juvenile idiopathic arthritis: joint recommendations from the French societies for rheumatology, radiology and pediatric rheumatology [41]

Acute monoarthritis: - XR of the involved joint should be performed in two perpendicular views to exclude a tumor, osteomyelitis, or hematological malignancy Comparative XR of the contralateral joint is unnecessary

Cervical spine: - Lateral XR of the cervical spine is only indicated if MRI is unavailable In the presence of neurological symptoms of spinal cord compression and neck pain, cervical MRI to be performed on an emergency basis

Enthesitis-related arthritis (ERA): - XR of the spine and hip joints are limited to the differential diagnosis - During the follow-up of axial ERA, XR may be considered (only for the hip joints), depending on the clinical course and availability of US and/or MRI XR is not recommended for multifocal enthesitis. If isolated enthesitis, XR can be considered as a tool for establishing the differential diagnosis (osteochondritis)

Hip joint: - Routine XR is not recommended in pJIA If XR of a symptomatic hip joint is performed, only a single view should be obtained (antero-posterior or frog leg view)

Oligoarticular JIA (oJIA): - Should be performed on affected joint(s) that remain symptomatica after 3 months (not routine diagnostic)b - In extended oJIA, apply recommendations for pJIA

Polyarticular JIA (pJIA): - If RF/ACPA+ , routine XR of the wrists, hands, and forefeet strongly recommended at time of diagnosis—1 year after disease onset and at transition from pediatric to adult healthcare - If RF/ACPA -, XR to be performed only in case of adverse prognostic factors (early involvement of wrists, symmetric arthritis, distal, small-joint arthritis, elevated ESR/CRP, pre-existing radiographic abnormalities) - In symptomatic* disease longer than 3 months, XR can be repeatedb

Temporomandibular joints: - If cross-sectional imaging is available, XR is not recommended

^aSymptomatic joints are painful and/or swollen joints and/or joints that have restricted mobility

^bThe selection and timing of specific follow-up imaging techniques to further assess structurally damaged joints is guided by clinical considerations

ERA enthesitis-related arthritis, JIA juvenile idiopathic arthritis, MRI magnetic resonance imaging, p polyarticular, o oligoarticular, US ultrasound, XR conventional radiography