Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.
Juvenile Rheumatoid Arthritis Imaging Studies and Other Tests
Your child's health care professional may order X-rays or similar
imaging studies. These images may help confirm the diagnosis of JRA or suggest other conditions that might cause similar symptoms.
X-rays: X-rays give information about whether or not damage has occurred in the joint.
Bone scan: A bone scan may be necessary if the results of the workup do not support the diagnosis of JRA. A bone scan can detect inflammation in the bone and other abnormalities that do not show up well on
MRI: MRI is similar to
X-ray but is much more detailed and gives a better three-dimensional view of the joint. It is especially useful if there has been a fall or accident that might have injured joints. It usually is not ordered unless the results of the workup do not point clearly to a diagnosis of JRA.
CT scan: CT scan also is similar to
X-ray but provides much greater detail. It may be ordered when the results of the workup do not support the diagnosis of JRA. CT scan is particularly good at ruling out tumors and other bony abnormalities that could cause arthritis-like symptoms.
Dual-energy X-ray absorptiometry (DEXA) scan: DEXA scanning is used to measure bone density and can identify osteopenia or osteoporosis (loss of bone tissue) in children with polyarticular JRA.
Other tests may be ordered in specific circumstances. Most children with JRA do not require these tests.
Synovial biopsy: An orthopedic surgeon uses a probe to remove a small amount of the synovial tissue from a joint. The tissue is examined under a microscope for clues as to what is causing synovial damage. This may be helpful to exclude other conditions that can cause symptoms similar to those of JRA.