A case of Kawasaki disease in which acute and convalescent MRI were useful for diagnosing the cause of arthritis and deciding the treatment strategy

Abstract

A patient with Kawasaki disease who had been treated with steroids was unable to walk because of pain in the hip and knee joints immediately after their discontinuation. An MRI examination revealed the presence of inflammation in both hip joints, no necrosis of the femoral head, and a low possibility of purulent hip arthritis. Thus, steroid treatment was safely resumed. The joint symptoms were promptly alleviated thereafter. A second MRI examination performed 6 months after the initial discontinuation of the steroid drug showed an improvement in the arthritis and the absence of chronic inflammatory diseases such as juvenile idiopathic arthritis. The arthritis in this case was determined to be a concomitant manifestation of Kawasaki disease. Acute and convalescent MRI examinations are useful for diagnosing the cause of arthritis in patients with Kawasaki disease and for determining the optimal treatment strategy.