title: Carpal erosions in children with juvenile idiopathic arthritis: repeatability of a newly devised MR-scoring system.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  Further analysis of erosive disease patterns compared with normal subjects is required, and to facilitate the development of an alternative means of quantifying disease.
authors.affiliation: Department of Radiology, Great Ormond Street Hospital for Children, London, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Boavida
authors.affiliation: Department of Radiology, Hospital Necker Enfants Malades, Paris, France.
authors.forename: Karen
authors.initials: K
authors.lastname: Lambot-Juhan
authors.affiliation: Department of Radiology, Oslo University Hospital, Oslo, Norway.
authors.forename: Lil-Sofie Ording
authors.initials: LS
authors.lastname: Müller
authors.affiliation: Department of Rheumatology, Ospedale Pediatrico Gaslini, Genoa, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Damasio
authors.affiliation: Department of Radiology, Ospedale Pediatrico Bambino Gesu, Rome, Italy.
authors.forename: Laura Tanturri
authors.initials: LT
authors.lastname: de Horatio
authors.affiliation: Department of Rheumatology, Ospedale Pediatrico Gaslini, Genoa, Italy.
authors.forename: Clara
authors.initials: C
authors.lastname: Malattia
authors.affiliation: Department of Radiology, Great Ormond Street Hospital for Children, London, UK.|Institute of Child Health, UCL, London, UK.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Owens
authors.affiliation: Department of Radiology, Haukeland University Hospital, Jonas Lies vei 65, N-5021, Bergen, Norway. Karen.rosendahl@helse-bergen.no.|Department of Clinical Medicine, University of Bergen, Bergen, Norway. Karen.rosendahl@helse-bergen.no.
authors.forename: Karen
authors.initials: K
authors.lastname: Rosendahl
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000473:pathology*; D002348:Carpal Bones / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012720:Severity of Illness Index
keywords: Child; Juvenile idiopathic arthritis; Magnetic resonance imaging; Reliability; Scoring system; Wrist