title: Current Status of Efforts on Standardizing Magnetic Resonance Imaging of Juvenile Idiopathic Arthritis: Report from the OMERACT MRI in JIA Working Group and Health-e-Child.
abstract: OBJECTIVE
  To report on the progress of an ongoing research collaboration on magnetic resonance imaging (MRI) in juvenile idiopathic arthritis (JIA) and describe the proceedings of a meeting, held prior to Outcome Measures in Rheumatology (OMERACT) 12, bringing together the OMERACT MRI in JIA working group and the Health-e-Child radiology group. The goal of the meeting was to establish agreement on scoring definitions, locations, and scales for the assessment of MRI of patients with JIA for both large and small joints.
  
  
  METHODS
  The collaborative work process included premeeting surveys, presentations, group discussions, consensus on scoring methods, pilot scoring, conjoint review, and discussion of a future research agenda.
  
  
  RESULTS
  The meeting resulted in preliminary statements on the MR imaging protocol of the JIA knee and wrist and determination of the starting point for development of MRI scoring systems based on previous studies. It was also considered important to be descriptive rather than explanatory in the assessment of MRI in JIA (e.g., "thickening" instead of "hypertrophy"). Further, the group agreed that well-designed calibration sessions were warranted before any future scoring exercises were conducted.
  
  
  CONCLUSIONS
  The combined efforts of the OMERACT MRI in JIA working group and Health-e-Child included the assessment of currently available material in the literature and determination of the basis from which to start the development of MRI scoring systems for both the knee and wrist. The future research agenda for the knee and wrist will include establishment of MRI scoring systems, an atlas of MR imaging in healthy children, and MRI protocol requisites.
authors.affiliation: From the Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands; Department of Radiology, Oslo University Hospital, Oslo, Norway; Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Radiology, University Hospital North Norway, Tromsø, Norway; Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany; Department of Pediatrics, University of Genoa, Genoa, Italy; Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen, Amsterdam, The Netherlands; Department of Clinical Medicine, K1, University of Bergen, and Department of Pediatric Radiology, Haukeland University Hospital, Bergen, Norway.C.M. Nusman, MSc, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; L.S. Ording Muller, MD, PhD, Department of Radiology, Oslo University Hospital; R. Hemke, MD, PhD, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; A.S. Doria, MD, PhD, Department of Diagnostic Imaging, The Hospital for Sick Children; D. Avenarius, MD, Department of Radiology, University Hospital North Norway; N. Tzaribachev, MD, Pediatric Rheumatology Research Institute; C. Malattia, MD, PhD, Department of Pediatrics, University of Genoa; M.A. van Rossum, MD, PhD, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, and Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen; M. Maas, MD, PhD, Department of Radiology, Academic Medical Center; K. Rosendahl, MD, PhD, Department o
authors.forename: Charlotte M
authors.initials: CM
authors.lastname: Nusman
authors.affiliation: From the Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands; Department of Radiology, Oslo University Hospital, Oslo, Norway; Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Radiology, University Hospital North Norway, Tromsø, Norway; Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany; Department of Pediatrics, University of Genoa, Genoa, Italy; Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen, Amsterdam, The Netherlands; Department of Clinical Medicine, K1, University of Bergen, and Department of Pediatric Radiology, Haukeland University Hospital, Bergen, Norway.C.M. Nusman, MSc, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; L.S. Ording Muller, MD, PhD, Department of Radiology, Oslo University Hospital; R. Hemke, MD, PhD, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; A.S. Doria, MD, PhD, Department of Diagnostic Imaging, The Hospital for Sick Children; D. Avenarius, MD, Department of Radiology, University Hospital North Norway; N. Tzaribachev, MD, Pediatric Rheumatology Research Institute; C. Malattia, MD, PhD, Department of Pediatrics, University of Genoa; M.A. van Rossum, MD, PhD, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, and Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen; M. Maas, MD, PhD, Department of Radiology, Academic Medical Center; K. Rosendahl, MD, PhD, Department o
authors.forename: Lil-Sofie
authors.initials: LS
authors.lastname: Ording Muller
authors.affiliation: From the Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands; Department of Radiology, Oslo University Hospital, Oslo, Norway; Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Radiology, University Hospital North Norway, Tromsø, Norway; Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany; Department of Pediatrics, University of Genoa, Genoa, Italy; Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen, Amsterdam, The Netherlands; Department of Clinical Medicine, K1, University of Bergen, and Department of Pediatric Radiology, Haukeland University Hospital, Bergen, Norway.C.M. Nusman, MSc, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; L.S. Ording Muller, MD, PhD, Department of Radiology, Oslo University Hospital; R. Hemke, MD, PhD, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; A.S. Doria, MD, PhD, Department of Diagnostic Imaging, The Hospital for Sick Children; D. Avenarius, MD, Department of Radiology, University Hospital North Norway; N. Tzaribachev, MD, Pediatric Rheumatology Research Institute; C. Malattia, MD, PhD, Department of Pediatrics, University of Genoa; M.A. van Rossum, MD, PhD, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, and Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen; M. Maas, MD, PhD, Department of Radiology, Academic Medical Center; K. Rosendahl, MD, PhD, Department o
authors.forename: Robert
authors.initials: R
authors.lastname: Hemke
authors.affiliation: From the Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands; Department of Radiology, Oslo University Hospital, Oslo, Norway; Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Radiology, University Hospital North Norway, Tromsø, Norway; Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany; Department of Pediatrics, University of Genoa, Genoa, Italy; Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen, Amsterdam, The Netherlands; Department of Clinical Medicine, K1, University of Bergen, and Department of Pediatric Radiology, Haukeland University Hospital, Bergen, Norway.C.M. Nusman, MSc, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; L.S. Ording Muller, MD, PhD, Department of Radiology, Oslo University Hospital; R. Hemke, MD, PhD, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; A.S. Doria, MD, PhD, Department of Diagnostic Imaging, The Hospital for Sick Children; D. Avenarius, MD, Department of Radiology, University Hospital North Norway; N. Tzaribachev, MD, Pediatric Rheumatology Research Institute; C. Malattia, MD, PhD, Department of Pediatrics, University of Genoa; M.A. van Rossum, MD, PhD, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, and Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen; M. Maas, MD, PhD, Department of Radiology, Academic Medical Center; K. Rosendahl, MD, PhD, Department o
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Doria
authors.affiliation: From the Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands; Department of Radiology, Oslo University Hospital, Oslo, Norway; Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Radiology, University Hospital North Norway, Tromsø, Norway; Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany; Department of Pediatrics, University of Genoa, Genoa, Italy; Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen, Amsterdam, The Netherlands; Department of Clinical Medicine, K1, University of Bergen, and Department of Pediatric Radiology, Haukeland University Hospital, Bergen, Norway.C.M. Nusman, MSc, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; L.S. Ording Muller, MD, PhD, Department of Radiology, Oslo University Hospital; R. Hemke, MD, PhD, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; A.S. Doria, MD, PhD, Department of Diagnostic Imaging, The Hospital for Sick Children; D. Avenarius, MD, Department of Radiology, University Hospital North Norway; N. Tzaribachev, MD, Pediatric Rheumatology Research Institute; C. Malattia, MD, PhD, Department of Pediatrics, University of Genoa; M.A. van Rossum, MD, PhD, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, and Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen; M. Maas, MD, PhD, Department of Radiology, Academic Medical Center; K. Rosendahl, MD, PhD, Department o
authors.forename: Derk
authors.initials: D
authors.lastname: Avenarius
authors.affiliation: From the Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands; Department of Radiology, Oslo University Hospital, Oslo, Norway; Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Radiology, University Hospital North Norway, Tromsø, Norway; Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany; Department of Pediatrics, University of Genoa, Genoa, Italy; Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen, Amsterdam, The Netherlands; Department of Clinical Medicine, K1, University of Bergen, and Department of Pediatric Radiology, Haukeland University Hospital, Bergen, Norway.C.M. Nusman, MSc, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; L.S. Ording Muller, MD, PhD, Department of Radiology, Oslo University Hospital; R. Hemke, MD, PhD, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; A.S. Doria, MD, PhD, Department of Diagnostic Imaging, The Hospital for Sick Children; D. Avenarius, MD, Department of Radiology, University Hospital North Norway; N. Tzaribachev, MD, Pediatric Rheumatology Research Institute; C. Malattia, MD, PhD, Department of Pediatrics, University of Genoa; M.A. van Rossum, MD, PhD, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, and Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen; M. Maas, MD, PhD, Department of Radiology, Academic Medical Center; K. Rosendahl, MD, PhD, Department o
authors.forename: Nikolay
authors.initials: N
authors.lastname: Tzaribachev
authors.affiliation: From the Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands; Department of Radiology, Oslo University Hospital, Oslo, Norway; Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Radiology, University Hospital North Norway, Tromsø, Norway; Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany; Department of Pediatrics, University of Genoa, Genoa, Italy; Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen, Amsterdam, The Netherlands; Department of Clinical Medicine, K1, University of Bergen, and Department of Pediatric Radiology, Haukeland University Hospital, Bergen, Norway.C.M. Nusman, MSc, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; L.S. Ording Muller, MD, PhD, Department of Radiology, Oslo University Hospital; R. Hemke, MD, PhD, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; A.S. Doria, MD, PhD, Department of Diagnostic Imaging, The Hospital for Sick Children; D. Avenarius, MD, Department of Radiology, University Hospital North Norway; N. Tzaribachev, MD, Pediatric Rheumatology Research Institute; C. Malattia, MD, PhD, Department of Pediatrics, University of Genoa; M.A. van Rossum, MD, PhD, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, and Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen; M. Maas, MD, PhD, Department of Radiology, Academic Medical Center; K. Rosendahl, MD, PhD, Department o
authors.forename: Clara
authors.initials: C
authors.lastname: Malattia
authors.affiliation: From the Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands; Department of Radiology, Oslo University Hospital, Oslo, Norway; Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Radiology, University Hospital North Norway, Tromsø, Norway; Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany; Department of Pediatrics, University of Genoa, Genoa, Italy; Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen, Amsterdam, The Netherlands; Department of Clinical Medicine, K1, University of Bergen, and Department of Pediatric Radiology, Haukeland University Hospital, Bergen, Norway.C.M. Nusman, MSc, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; L.S. Ording Muller, MD, PhD, Department of Radiology, Oslo University Hospital; R. Hemke, MD, PhD, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; A.S. Doria, MD, PhD, Department of Diagnostic Imaging, The Hospital for Sick Children; D. Avenarius, MD, Department of Radiology, University Hospital North Norway; N. Tzaribachev, MD, Pediatric Rheumatology Research Institute; C. Malattia, MD, PhD, Department of Pediatrics, University of Genoa; M.A. van Rossum, MD, PhD, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, and Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen; M. Maas, MD, PhD, Department of Radiology, Academic Medical Center; K. Rosendahl, MD, PhD, Department o
authors.forename: Marion A J
authors.initials: MA
authors.lastname: van Rossum
authors.affiliation: From the Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands; Department of Radiology, Oslo University Hospital, Oslo, Norway; Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Radiology, University Hospital North Norway, Tromsø, Norway; Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany; Department of Pediatrics, University of Genoa, Genoa, Italy; Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen, Amsterdam, The Netherlands; Department of Clinical Medicine, K1, University of Bergen, and Department of Pediatric Radiology, Haukeland University Hospital, Bergen, Norway.C.M. Nusman, MSc, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; L.S. Ording Muller, MD, PhD, Department of Radiology, Oslo University Hospital; R. Hemke, MD, PhD, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; A.S. Doria, MD, PhD, Department of Diagnostic Imaging, The Hospital for Sick Children; D. Avenarius, MD, Department of Radiology, University Hospital North Norway; N. Tzaribachev, MD, Pediatric Rheumatology Research Institute; C. Malattia, MD, PhD, Department of Pediatrics, University of Genoa; M.A. van Rossum, MD, PhD, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, and Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen; M. Maas, MD, PhD, Department of Radiology, Academic Medical Center; K. Rosendahl, MD, PhD, Department o
authors.forename: Mario
authors.initials: M
authors.lastname: Maas
authors.affiliation: From the Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands; Department of Radiology, Oslo University Hospital, Oslo, Norway; Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Radiology, University Hospital North Norway, Tromsø, Norway; Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany; Department of Pediatrics, University of Genoa, Genoa, Italy; Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen, Amsterdam, The Netherlands; Department of Clinical Medicine, K1, University of Bergen, and Department of Pediatric Radiology, Haukeland University Hospital, Bergen, Norway.C.M. Nusman, MSc, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; L.S. Ording Muller, MD, PhD, Department of Radiology, Oslo University Hospital; R. Hemke, MD, PhD, Department of Radiology, Academic Medical Center; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center; A.S. Doria, MD, PhD, Department of Diagnostic Imaging, The Hospital for Sick Children; D. Avenarius, MD, Department of Radiology, University Hospital North Norway; N. Tzaribachev, MD, Pediatric Rheumatology Research Institute; C. Malattia, MD, PhD, Department of Pediatrics, University of Genoa; M.A. van Rossum, MD, PhD, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Academic Medical Center, and Department of Pediatric Rheumatology, Reade Institute, location Jan van Breemen; M. Maas, MD, PhD, Department of Radiology, Academic Medical Center; K. Rosendahl, MD, PhD, Department o
authors.forename: Karen
authors.initials: K
authors.lastname: Rosendahl
mesh_terms: D001171:Arthritis, Juvenile / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002648:Child; D003245:Consensus Statements as Topic; D005260:Female; D006621:Hip Joint / Q000473:pathology; D006801:Humans; D007719:Knee Joint / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000592:standards*; D008297:Male; D017410:Practice Guidelines as Topic / Q000592:standards; D012219:Rheumatology / Q000592:standards; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014955:Wrist Joint / Q000473:pathology
keywords: JUVENILE IDIOPATHIC ARTHRITIS; MAGNETIC RESONANCE IMAGING; OMERACT; SCORING SYSTEMS