Pediatric Radiology

, Volume 42, Issue 9, pp 1047–1055

MRI of the wrist in juvenile idiopathic arthritis: proposal of a paediatric synovitis score by a consensus of an international working group. Results of a multicentre reliability study

Authors

    • Department of RadiologyOspedale Pediatrico Gaslini
  • Clara Malattia
    • Department of PaediatricsUniversity of Genova
  • Laura Tanturri de Horatio
    • Department of RadiologyOspedale Pediatrico Bambino Gesu
  • Chiara Mattiuz
    • Department of RadiologyOspedale Pediatrico Gaslini
  • Angela Pistorio
    • Department of Epidemiology and BiostatisticsOspedale pediatrico Gaslini
  • Claudia Bracaglia
    • Department of RheumatologyOspedale Pediatrico Bambino Gesù
  • Domenico Barbuti
    • Department of RadiologyOspedale Pediatrico Bambino Gesu
  • Peter Boavida
    • Department of RadiologyGreat Ormond Street Hospital for Children
  • Karen Lambot Juhan
    • Department of RadiologyHopital Necker Enfants Malades
  • Lil Sophie Mueller Ording
    • Department of RadiologyGreat Ormond Street Hospital for Children
  • Karen Rosendahl
    • Department of RadiologyUniversity Hospital North Norway
  • Alberto Martini
    • Department of PaediatricsUniversity of Genova
  • GianMichele Magnano
    • Department of RadiologyOspedale Pediatrico Gaslini
  • Paolo Tomà
    • Department of RadiologyOspedale Pediatrico Bambino Gesu
Original Article

DOI: 10.1007/s00247-012-2392-4

Cite this article as:
Damasio, M.B., Malattia, C., Tanturri de Horatio, L. et al. Pediatr Radiol (2012) 42: 1047. doi:10.1007/s00247-012-2392-4

Abstract

Background

MRI is a sensitive tool for the evaluation of synovitis in juvenile idiopathic arthritis (JIA).

Objective

The purpose of this study was to introduce a novel MRI-based score for synovitis in children and to examine its inter- and intraobserver variability in a multi-centre study.

Materials and methods

Wrist MRI was performed in 76 children with JIA. On postcontrast 3-D spoiled gradient-echo and fat-suppressed T2-weighted spin-echo images, joint recesses were scored for the degree of synovial enhancement, effusion and overall inflammation independently by two paediatric radiologists. Total-enhancement and inflammation-synovitis scores were calculated.

Results

Interobserver agreement was poor to moderate for enhancement and inflammation in all recesses, except in the radioulnar and radiocarpal joints. Intraobserver agreement was good to excellent. For enhancement and inflammation scores, mean differences (95 % CI) between observers were −1.18 (−4.79 to 2.42) and −2.11 (−6.06 to 1.83). Intraobserver variability (reader 1) was 0 (−1.65 to 1.65) and 0.02 (−1.39 to 1.44).

Conclusion

Intraobserver agreement was good. Except for the radioulnar and radiocarpal joints, interobserver agreement was not acceptable. Therefore, the proposed scoring system requires further refinement.

Keywords

WristMRISynovitisJuvenile idiopathic arthritis

Copyright information

© Springer-Verlag 2012