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 multi-centre study.
  
  
  METHODS
  Wrist MRI was performed in 76 children with JIA. On postcontrast 3-D spoiled gradient-echo 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. Total-enhancement 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).
  
  
  CONCLUSIONS
  Intraobserver agreement was good. Except for the radioulnar and radiocarpal joints, interobserver agreement was not acceptable. Therefore, the proposed scoring system requires further refinement.
authors: Department of Radiology, Ospedale Pediatrico Gaslini, Genova, Italy. beatrice.damasio@libero.it
authors: Maria Beatrice
authors: MB
authors: Damasio
authors: Clara
authors: C
authors: Malattia
authors: Laura
authors: L
authors: Tanturri de Horatio
authors: Chiara
authors: C
authors: Mattiuz
authors: Angela
authors: A
authors: Pistorio
authors: Claudia
authors: C
authors: Bracaglia
authors: Domenico
authors: D
authors: Barbuti
authors: Peter
authors: P
authors: Boavida
authors: Karen Lambot
authors: KL
authors: Juhan
authors: Lil Sophie Mueller
authors: LS
authors: Ording
authors: Karen
authors: K
authors: Rosendahl
authors: Alberto
authors: A
authors: Martini
authors: GianMichele
authors: G
authors: Magnano
authors: Paolo
authors: P
authors: Tomà
mesh_terms: D001171:Arthritis, Juvenile / Q000175:diagnosis*; D002675:Child, Preschool; D005060:Europe; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D038622:Internationality; D008297:Male; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014955:Wrist Joint / Q000473:pathology*