The reliability of Juvenile Arthritis Magnetic Resonance Imaging Scoring system in the evaluation of the shoulder joint in juvenile idiopathic arthritis
1Department of Pediatrics, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
2Department of Radiodiagnosis, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
Keywords: Clinical examination, juvenile idiopathic arthritis, magnetic resonance imaging, shoulder joint.
Objectives: We aimed to evaluate shoulder joint by magnetic resonance imaging (MRI) using the Juvenile Arthritis Magnetic Resonance Imaging Scoring (JAMRIS) system in children with juvenile idiopathic arthritis (JIA) and to compare clinical, laboratory parameters and disease activity scores with MRI parameters.
Patients and methods: A total of 32 shoulder joints of 20 patients (16 males, 4 females; mean age: 8.9±3.5 years; range, 2.5 to 14 years) with a known diagnosis of JIA and a clinical suspicion of shoulder joint involvement and underwent MRI were included. Reliability was determined by inter- and intra-observer correlation coefficients. Correlation of the clinical and laboratory parameters with JAMRIS scores was done using the non-parametric tests. Sensitivity of clinical examination to detect shoulder joint arthritis was also determined.
Results: Of the 32 joints, 27 joints in 17 patients showed MRI changes. Seven joints in five patients fulfilled the definition of clinical arthritis, all revealed MRI changes. In 25 joints without clinical arthritis, early and late MRI changes were seen in 19 (67%) and 12 (48%) joints, respectively. The inter- and intra-observer correlation coefficients for JAMRIS system were excellent. No correlation was found between MRI parameters, clinical, laboratory, and disease activity scores. The sensitivity of clinical examination to detect shoulder joint arthritis was 25.9%.
Conclusion: The JAMRIS system is reliable and reproducible to determine shoulder joint inflammation in JIA. Detection of shoulder joint arthritis by clinical examination has a poor sensitivity
Citation: Sudhakar M, Deswal S, Sachdev N, Pal S, Yadav TP. The reliability of Juvenile Arthritis Magnetic Resonance Imaging Scoring System in the evaluation of the shoulder joint in juvenile idiopathic arthritis. Arch Rheumatol 2022;37(4):547-558.
The study protocol was approved by the Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital Ethics Committee (date: 2014, no: 1-40/62/2014). The study was conducted in accordance with the principles of the Declaration of Helsinki.
A written informed consent was obtained from the parents and/or legal guardians of the patients.
Data Sharing Statement:
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Data collection, data analysis, writing of initial draft of manuscript, editing and revision of manuscript at all stages of its production, review of literature: M.S.; Evaluation and management of the patient, follow up of the patient, data analysis, editing and approval of the manuscript: S.D.; Protocol for MRI assessment, data collection, data analysis, intellectual input editing of manuscript evaluation: N.S.; Management and follow up of the patient,data analysis, intellectual input , editing of manuscript: S.P.; Inception of idea, Data analysis, evaluation, management and follow up of the patient and editing of manuscript, critical revision of the manuscript at all stages of production and final approval, guarantor of paper: T.P.Y.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
We acknowledge the statistical analysis done by Mrs. Parul Chugh, statistician.