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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

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An Erratum to this article was published on 20 October 2012

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.

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Acknowledgement

Supported by a grant from the European Union, Health-e-Child Integrated Project (IST-2004-027749).

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Authors and Affiliations

  1. Department of Radiology, Ospedale Pediatrico Gaslini, Genova, Italy

    Maria Beatrice Damasio, Chiara Mattiuz & GianMichele Magnano

  2. Department of Paediatrics, University of Genova, Genova, Italy

    Clara Malattia & Alberto Martini

  3. Department of Radiology, Ospedale Pediatrico Bambino Gesu, Rome, Italy

    Laura Tanturri de Horatio, Domenico Barbuti & Paolo Tomà

  4. Department of Epidemiology and Biostatistics, Ospedale pediatrico Gaslini, Genova, Italy

    Angela Pistorio

  5. Department of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy

    Claudia Bracaglia

  6. Department of Radiology, Great Ormond Street Hospital for Children, London, UK

    Peter Boavida & Lil Sophie Mueller Ording

  7. Department of Radiology, Hopital Necker Enfants Malades, Paris, France

    Karen Lambot Juhan

  8. Department of Radiology, University Hospital North Norway, Tromsø, Norway

    Karen Rosendahl

Authors
  1. Maria Beatrice Damasio
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  2. Clara Malattia
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  3. Laura Tanturri de Horatio
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  11. Karen Rosendahl
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  12. Alberto Martini
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  13. GianMichele Magnano
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  14. Paolo Tomà
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Corresponding author

Correspondence to Maria Beatrice Damasio.

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Damasio, M.B., Malattia, C., Tanturri de Horatio, L. et al. 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. Pediatr Radiol 42, 1047–1055 (2012). https://doi.org/10.1007/s00247-012-2392-4

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  • DOI: https://doi.org/10.1007/s00247-012-2392-4

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