European Radiology

, Volume 23, Issue 4, pp 1075–1083 | Cite as

Reliability and responsiveness of the Juvenile Arthritis MRI Scoring (JAMRIS) system for the knee

  • Robert HemkeEmail author
  • Marion A. J. van Rossum
  • Mira van Veenendaal
  • Maaike P. Terra
  • Eline E. Deurloo
  • Milko C. de Jonge
  • J. Merlijn van den Berg
  • Koert M. Dolman
  • Taco W. Kuijpers
  • Mario Maas



To assess the reliability and responsiveness of a new Juvenile Arthritis MRI Scoring (JAMRIS) system for evaluating disease activity of the knee.


Twenty-five juvenile idiopathic arthritis (JIA) patients with clinical knee involvement were studied using open-bore 1-T MRI. MRI features of synovial hypertrophy, bone marrow changes, cartilage lesions and bone erosions were independently scored by five readers using the JAMRIS system. In addition, the JAMRIS system was determined to be a follow-up parameter by two readers to evaluate the response to therapy in 15 consecutive JIA patients.


Inter-reader (ICCs 0.86–0.95) and intra-reader reliability (ICCs 0.92–1.00) for the scoring of JAMRIS features was good. Reliability of the actual scores and changes in scores over time was good for all items: ICCs 0.89–1.00, 0.87–1.00, respectively. Concerning therapy response, the mean synovial hypertrophy scores decreased significantly (mean 1.1 point; P < 0.001, SRM = −0.65). No change was observed with respect to bone marrow change, cartilage lesion and bone erosion scores.


The JAMRIS proved to be a simple and highly reliable assessment score in the evaluation of JIA disease activity of the knee. The JAMRIS system may serve as an objective and accurate outcome measure in future research and clinical trials.

Key Points

MRI is increasingly used to diagnose and assess juvenile idiopathic arthritis.

A simple and reliable scoring method would help monitor progress and research.

The Juvenile Arthritis MRI Scoring (JAMRIS) system provides reliable objective measures.

JAMRIS evaluates synovial hypertrophy, bone marrow changes, cartilage lesions and bone erosions.

The JAMRIS system can detect therapeutic response and should help future research.


Juvenile idiopathic arthritis Magnetic resonance imaging Outcome measure Reliability Knee joint 



A research grant was received from the Reumafonds, Dutch Arthritis Association (Amsterdam, The Netherlands). The Dutch Arthritis Association was not involved in designing and conducting this study, did not have access to the data, and was not involved in data analysis or preparation of this manuscript.

Supplementary material

330_2012_2684_MOESM1_ESM.pdf (466 kb)
ESM 1 (PDF 465 kb)


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Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • Robert Hemke
    • 1
    • 2
    Email author
  • Marion A. J. van Rossum
    • 2
    • 3
  • Mira van Veenendaal
    • 2
  • Maaike P. Terra
    • 1
  • Eline E. Deurloo
    • 1
  • Milko C. de Jonge
    • 4
  • J. Merlijn van den Berg
    • 2
    • 3
  • Koert M. Dolman
    • 3
    • 5
  • Taco W. Kuijpers
    • 2
  • Mario Maas
    • 1
  1. 1.Department of Radiology, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  2. 2.Department of Paediatric Haematology, Immunology, Rheumatology and Infectious Disease, Emma Children’s Hospital AMCUniversity of AmsterdamAmsterdamThe Netherlands
  3. 3.Department of Paediatric RheumatologyReadeAmsterdamThe Netherlands
  4. 4.Department of RadiologyZuwe Hofpoort HospitalWoerdenThe Netherlands
  5. 5.Department of Paediatric RheumatologySt. Lucas Andreas HospitalAmsterdamThe Netherlands

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