Carpal erosions in children with juvenile idiopathic arthritis: repeatability of a newly devised MR-scoring system

Peter Boavida, Karen Lambot-Juhan, Lil Sofie Ording Müller, Beatrice Damasio, Laura Tanturri de Horatio, Clara Malattia, Catherine M. Owens, Karen Rosendahl

Research output: Contribution to journalArticlepeer-review


Background: 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. Objective: 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. Results: 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. Conclusion: Further analysis of erosive disease patterns compared with normal subjects is required, and to facilitate the development of an alternative means of quantifying disease.

Original languageEnglish
Pages (from-to)1972-1980
Number of pages9
JournalPediatric Radiology
Issue number13
Publication statusPublished - Dec 1 2015


  • Child
  • Juvenile idiopathic arthritis
  • Magnetic resonance imaging
  • Reliability
  • Scoring system
  • Wrist

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pediatrics, Perinatology, and Child Health


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