Juvenile Arthritis: Current Treatment and Future Advances

“Our research with advanced imaging aims to help the child we see today as well as our future pediatric patients.” John MacKenzie, MD, is a renown expert in the imaging of the pediatric musculoskeletal system.

“Though rare, arthritis in children is extremely debilitating. For this reason, it is a subject to which I have dedicated a great deal of attention as a pediatric radiologist.”

In juvenile arthritis, the immune system attacks the joints. The joints become red, swollen and eventually they fuse, which severely limits their mobility and function. The challenges of pediatric radiology include imaging child-sized joints, and keeping radiation low.

“It is encouraging to work with the world’s leaders in juvenile arthritis research and treatment,” said Dr. MacKenzie. “Our team of pediatric radiologists works with pediatric rheumatologists to help diagnose juvenile arthritis through a variety of imaging techniques, including MRI, radiographs, ultrasound, and sometimes CT. We are also testing exciting new imaging approaches including PET/MRI, a new hybrid imaging technology that incorporates magnetic resonance imaging (MRI) and positron emission tomography (PET) functional imaging. The state-of-the-art PET/MRI equipment and technical team at UCSF allows us to look at smaller joints with more clarity and lower dose radiation.”

Accurate diagnosis is extremely important as arthritis is difficult to treat. “Our scans, along with clinical and lab reports, are integrated into the final diagnosis,” said Dr. Mackenzie. “The PET/MRI research is one area of intense focus where we hope to help children with juvenile arthritis and adults with rheumatoid arthritis. PET/MRI is the next generation of imaging and helps us to understand the function of the disease and to precisely identify the activity of a child's immune system.

“We can also use radiology tools to treat patients,” said Dr. MacKenzie. “At UCSF, we use image-guided technologies to inject medication directly into affected joints. This is critical for juvenile patients because it provides an alternative to systemic medicine. By targeting medication delivery, we make it less invasive to the body, and more effective in treating the arthritis.

“Together, in our research and as clinicians, we have the privilege of rapidly applying advances in juvenile arthritis treatment that can help our patients right now, while continuing to learn more that we can apply going forward.”

John MacKenzie, MD, is an associate professor in residence, chief of radiology at UCSF Mission Bay Medical Center, and section chief of Pediatric Radiology. He is a nationally recognized expert in the imaging of the pediatric musculoskeletal system and his research focuses on developing imaging techniques for the detection and treatment monitoring of autoimmune diseases of the bones and joints.