Carpal erosions in children with juvenile idiopathic arthritis: repeatability of a newly devised MR-scoring system
- 262 Downloads
Juvenile idiopathic arthritis (JIA) is characterized by synovial inflammation, with potential risk of developing progressive joint destruction. Personalized state-of-the-art treatment depends on valid markers for disease activity to monitor response; however, no such markers exist.
To evaluate the reliability of scoring of carpal bone erosions on MR in children with JIA using two semi-quantitative scoring systems.
Materials and methods
A total of 1,236 carpal bones (91 MR wrist examinations) were scored twice by two independent pediatric musculoskeletal radiologists. Bony erosions were scored according to estimated bone volume loss using a 0–4 scale and a 0–10 scale. An aggregate erosion score comprising the sum total carpal bone volume loss was calculated for each examination.
The 0–4 scoring system resulted in good intra-reader agreement and moderate to good inter-observer agreement in the assessment of individual bones. Fair and moderate agreement were achieved for inter-reader and intra-reader agreement, respectively, using the 0–10 scale. Intra- and particularly inter-reader aggregate score variability were much less favorable, with wide limits of agreement.
Further analysis of erosive disease patterns compared with normal subjects is required, and to facilitate the development of an alternative means of quantifying disease.
KeywordsChild Juvenile idiopathic arthritis Magnetic resonance imaging Reliability Scoring system Wrist
Conflicts of interest
- 5.Beukelman T, Patkar NM, Saag KG et al (2011) 2011 American college of rheumatology recommendations for the treatment of juvenile idiopathic arthritis: initiation and safety monitoring of therapeutic agents for the treatment of arthritis and systemic features. Arthritis Care Res (Hoboken) 63:465–482CrossRefGoogle Scholar
- 7.Otten MH, Anink J, Prince FH, Twilt M, Vastert SJ, Ten CR et al (2014) Trends in prescription of biological agents and outcomes of juvenile idiopathic arthritis: results of the Dutch national arthritis and biologics in children register. Ann Rheum DisGoogle Scholar
- 12.Malattia C, Damasio MB, Basso C, Santoro M, Verri A, Pederzoli S et al (2012) A novel automated system for MRI quantification of the inflamed synovial membrane volume in patients with juvenile idiopathic arthritis. Arthritis Care Res (Hoboken)Google Scholar
- 18.Ording Muller LS, Boavida P, Avenarius D, Damasio B, Eldevik OP, Malattia C et al (2013) MRI of the wrist in juvenile idiopathic arthritis: erosions or normal variants? A prospective case–control study. Pediatr RadiolGoogle Scholar