TY - JOUR
T1 - Development and initial validation of a radiographic scoring system for the hip in juvenile idiopathic arthritis
AU - Bertamino, Marta
AU - Rossi, Federica
AU - Pistorio, Angela
AU - Lucigrai, Giorgio
AU - Valle, Maura
AU - Viola, Stefania
AU - Magni-Manzoni, Silvia
AU - Malattia, Clara
AU - Martini, Alberto
AU - Ravelli, Angelo
PY - 2010/2
Y1 - 2010/2
N2 - Objective. To develop and validate a radiographic scoring system for the assessment of radiographic damage in the hip joint in patients with juvenile idiopathic arthritis (JIA). Methods. The Childhood Arthritis Radiographic Score of the Hip (CARSH) assesses and scores these radiographic abnormalities: joint space narrowing (JSN), erosion, growth abnormalities, subchondral cysts, malalignment, sclerosis of the acetabulum, and avascular necrosis of the femoral head. Score validation was accomplished by evaluating reliability and correlational, construct, and predictive validity in 148 JIA patients with hip disease who had a total of 381 hip radiographs available for study. Results. JSN was the most frequently observed radiographic abnormality, followed by erosion and sclerosis of the acetabulum. The least common abnormalities were avascular necrosis, growth abnormalities, and malalignment. Interobserver and intraobserver reliability on baseline and longitudinal score values and on score changes was good, with intraclass correlation coefficients ranging from 0.76 to 0.98. Early score changes, but not absolute baseline score values, were moderately correlated (r
s > 0.4) with clinical indicators of disease damage at last followup observation, thereby demonstrating that the CARSH has good construct and predictive validity. The amount of structural damage in the hip radiograph at last followup observation was predicted better by baseline to 1-year score change (r
s = 0.66; p <0.0001) than by absolute baseline score values (r
s = 0.40; p = 0.002). Conclusion. Our results show that the CARSH is reliable and valid for the assessment of radiographic hip damage and its progression in patients with JIA.
AB - Objective. To develop and validate a radiographic scoring system for the assessment of radiographic damage in the hip joint in patients with juvenile idiopathic arthritis (JIA). Methods. The Childhood Arthritis Radiographic Score of the Hip (CARSH) assesses and scores these radiographic abnormalities: joint space narrowing (JSN), erosion, growth abnormalities, subchondral cysts, malalignment, sclerosis of the acetabulum, and avascular necrosis of the femoral head. Score validation was accomplished by evaluating reliability and correlational, construct, and predictive validity in 148 JIA patients with hip disease who had a total of 381 hip radiographs available for study. Results. JSN was the most frequently observed radiographic abnormality, followed by erosion and sclerosis of the acetabulum. The least common abnormalities were avascular necrosis, growth abnormalities, and malalignment. Interobserver and intraobserver reliability on baseline and longitudinal score values and on score changes was good, with intraclass correlation coefficients ranging from 0.76 to 0.98. Early score changes, but not absolute baseline score values, were moderately correlated (r
s > 0.4) with clinical indicators of disease damage at last followup observation, thereby demonstrating that the CARSH has good construct and predictive validity. The amount of structural damage in the hip radiograph at last followup observation was predicted better by baseline to 1-year score change (r
s = 0.66; p <0.0001) than by absolute baseline score values (r
s = 0.40; p = 0.002). Conclusion. Our results show that the CARSH is reliable and valid for the assessment of radiographic hip damage and its progression in patients with JIA.
KW - Hip joint
KW - Juvenile idiopathic arthritis
KW - Radiographic progression
KW - Radiographic scoring
KW - Structural damage
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U2 - 10.3899/jrheum.090691
DO - 10.3899/jrheum.090691
M3 - Article
C2 - 20032107
AN - SCOPUS:76649131974
VL - 37
SP - 432
EP - 439
JO - Journal of Rheumatology
JF - Journal of Rheumatology
SN - 0315-162X
IS - 2
ER -