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 Damasio, 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

Research output: Contribution to journalArticle

Abstract

Background: MRI is a sensitive tool for the evaluation of synovitis in juvenile idiopathic arthritis (JIA). Objective: 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 multicentre study. Materials and methods: Wrist MRI was performed in 76 children with JIA. On postcontrast 3-D spoiled gradientecho 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. Totalenhancement and inflammation-synovitis scores were calculated. Results: 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). Conclusion Intraobserver agreement was good. Except for the radioulnar and radiocarpal joints, interobserver agreement was not acceptable. Therefore, the proposed scoring system requires further refinement.

Original languageEnglish
Pages (from-to)1047-1055
Number of pages9
JournalPediatric Radiology
Volume42
Issue number9
DOIs
Publication statusPublished - Sep 2012

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Synovitis
Juvenile Arthritis
Wrist
Multicenter Studies
Pediatrics
Inflammation
Observer Variation
Joints
Fats

Keywords

  • Juvenile idiopathic arthritis
  • MRI
  • Synovitis
  • Wrist

ASJC Scopus subject areas

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

Cite this

@article{89bca79a844642f8afa58366d4d7edf8,
title = "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",
abstract = "Background: MRI is a sensitive tool for the evaluation of synovitis in juvenile idiopathic arthritis (JIA). Objective: 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 multicentre study. Materials and methods: Wrist MRI was performed in 76 children with JIA. On postcontrast 3-D spoiled gradientecho 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. Totalenhancement and inflammation-synovitis scores were calculated. Results: 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). Conclusion Intraobserver agreement was good. Except for the radioulnar and radiocarpal joints, interobserver agreement was not acceptable. Therefore, the proposed scoring system requires further refinement.",
keywords = "Juvenile idiopathic arthritis, MRI, Synovitis, Wrist",
author = "Damasio, {Maria Beatrice} and Clara Malattia and {Tanturri De Horatio}, Laura and Chiara Mattiuz and Angela Pistorio and Claudia Bracaglia and Domenico Barbuti and Peter Boavida and Juhan, {Karen Lambot} and Ording, {Lil Sophie Mueller} and Karen Rosendahl and Alberto Martini and Gianmichele Magnano and Paolo Tom{\`a}",
year = "2012",
month = "9",
doi = "10.1007/s00247-012-2392-4",
language = "English",
volume = "42",
pages = "1047--1055",
journal = "Pediatric Radiology",
issn = "0301-0449",
publisher = "Springer Verlag",
number = "9",

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TY - JOUR

T1 - MRI of the wrist in juvenile idiopathic arthritis

T2 - Proposal of a paediatric synovitis score by a consensus of an international working group. Results of a multicentre reliability study

AU - Damasio, Maria Beatrice

AU - Malattia, Clara

AU - Tanturri De Horatio, Laura

AU - Mattiuz, Chiara

AU - Pistorio, Angela

AU - Bracaglia, Claudia

AU - Barbuti, Domenico

AU - Boavida, Peter

AU - Juhan, Karen Lambot

AU - Ording, Lil Sophie Mueller

AU - Rosendahl, Karen

AU - Martini, Alberto

AU - Magnano, Gianmichele

AU - Tomà, Paolo

PY - 2012/9

Y1 - 2012/9

N2 - Background: MRI is a sensitive tool for the evaluation of synovitis in juvenile idiopathic arthritis (JIA). Objective: 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 multicentre study. Materials and methods: Wrist MRI was performed in 76 children with JIA. On postcontrast 3-D spoiled gradientecho 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. Totalenhancement and inflammation-synovitis scores were calculated. Results: 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). Conclusion Intraobserver agreement was good. Except for the radioulnar and radiocarpal joints, interobserver agreement was not acceptable. Therefore, the proposed scoring system requires further refinement.

AB - Background: MRI is a sensitive tool for the evaluation of synovitis in juvenile idiopathic arthritis (JIA). Objective: 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 multicentre study. Materials and methods: Wrist MRI was performed in 76 children with JIA. On postcontrast 3-D spoiled gradientecho 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. Totalenhancement and inflammation-synovitis scores were calculated. Results: 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). Conclusion Intraobserver agreement was good. Except for the radioulnar and radiocarpal joints, interobserver agreement was not acceptable. Therefore, the proposed scoring system requires further refinement.

KW - Juvenile idiopathic arthritis

KW - MRI

KW - Synovitis

KW - Wrist

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