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Reliability of the Preliminary OMERACT Juvenile Idiopathic Arthritis MRI Score (OMERACT JAMRIS-SIJ)

Tarimobo M Otobo1, Nele Herregods2, Jacob L Jaremko3

  • 1Department of Diagnostic Radiology, Hospital for SickKids, Toronto, ON M5G 1X8, Canada.

Journal of Clinical Medicine
|October 13, 2021
PubMed

Insights

The juvenile idiopathic arthritis MRI scoring system (JAMRIS-SIJ) shows good reliability for bone marrow edema and ankylosis. Further refinement is needed for other JAMRIS-SIJ items to improve assessment of juvenile spondylarthritis.

Area of Science:

  • Rheumatology
  • Radiology
  • Medical Imaging

Background:

  • Juvenile idiopathic arthritis (JIA) encompasses several subtypes, including enthesitis-related juvenile spondylarthritis (JIA-ERA).
  • Accurate assessment of sacroiliac joint (SIJ) involvement in JIA-ERA is crucial for diagnosis and monitoring disease progression.
  • Standardized scoring systems for MRI evaluation of JIA-SIJ are needed to ensure reliable and reproducible assessments.

Purpose of the Study:

  • To evaluate the inter-rater reliability of the juvenile idiopathic arthritis magnetic resonance imaging scoring system for sacroiliac joints (JAMRIS-SIJ).
  • To assess the reliability of individual JAMRIS-SIJ items for inflammation and damage components in patients with JIA-ERA.

Main Methods:

  • Thirty coronal T1 and Short-Tau Inversion Recovery (STIR) MRI scans of patients with JIA-ERA were reviewed by eight raters (two rheumatologists, six radiologists).
  • Inter-rater agreement for each JAMRIS-SIJ item was calculated using a two-way random effects, absolute agreement, single rater intraclass correlation coefficient (ICC 2.1).
  • ICC values were interpreted alongside kurtosis to account for score distribution.

Main Results:

  • Good inter-rater reliability (ICC > 0.75) was observed for bone marrow edema (BME) (ICC=0.76) and ankylosis (ICC=0.89).
  • Variable and below-threshold reliability was found for other items, including joint space inflammation (ICC=0.60), capsulitis (ICC=0.58), enthesitis (ICC=0.20), sclerosis (ICC=0.53), erosion (ICC=0.50), fat lesion (ICC=0.40), and backfill (ICC=0.38).
  • High kurtosis values for several items indicated skewed score distributions, potentially influencing ICC results.

Conclusions:

  • The JAMRIS-SIJ demonstrates acceptable reliability for assessing bone marrow edema and ankylosis in JIA-ERA sacroiliitis.
  • Significant variability in inter-rater reliability for other JAMRIS-SIJ items suggests a need for score refinement and clearer definitions.
  • Further validation and refinement of the JAMRIS-SIJ are recommended before widespread clinical adoption for assessing JIA-ERA sacroiliitis.
Keywords:
JIAMRIOMERACTSIJmeasurement instrumentoutcome measurereliability

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