Pediatric Radiology

, Volume 42, Issue 9, pp 1047–1055 | Cite as

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

  • Maria Beatrice DamasioEmail author
  • Clara Malattia
  • Laura Tanturri de Horatio
  • Chiara Mattiuz
  • Angela Pistorio
  • Claudia Bracaglia
  • Domenico Barbuti
  • Peter Boavida
  • Karen Lambot Juhan
  • Lil Sophie Mueller Ording
  • Karen Rosendahl
  • Alberto Martini
  • GianMichele Magnano
  • Paolo Tomà
Original Article



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


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.


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).


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


Wrist MRI Synovitis Juvenile idiopathic arthritis 



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


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Maria Beatrice Damasio
    • 1
    Email author
  • Clara Malattia
    • 2
  • Laura Tanturri de Horatio
    • 3
  • Chiara Mattiuz
    • 1
  • Angela Pistorio
    • 4
  • Claudia Bracaglia
    • 5
  • Domenico Barbuti
    • 3
  • Peter Boavida
    • 6
  • Karen Lambot Juhan
    • 7
  • Lil Sophie Mueller Ording
    • 6
  • Karen Rosendahl
    • 8
  • Alberto Martini
    • 2
  • GianMichele Magnano
    • 1
  • Paolo Tomà
    • 3
  1. 1.Department of RadiologyOspedale Pediatrico GasliniGenovaItaly
  2. 2.Department of PaediatricsUniversity of GenovaGenovaItaly
  3. 3.Department of RadiologyOspedale Pediatrico Bambino GesuRomeItaly
  4. 4.Department of Epidemiology and BiostatisticsOspedale pediatrico GasliniGenovaItaly
  5. 5.Department of RheumatologyOspedale Pediatrico Bambino GesùRomeItaly
  6. 6.Department of RadiologyGreat Ormond Street Hospital for ChildrenLondonUK
  7. 7.Department of RadiologyHopital Necker Enfants MaladesParisFrance
  8. 8.Department of RadiologyUniversity Hospital North NorwayTromsøNorway

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