Header

UZH-Logo

Maintenance Infos

Towards Establishing a Standardized Magnetic Resonance Imaging Scoring System for Temporomandibular Joints in Juvenile Idiopathic Arthritis


Tolend, Mirkamal A; Twilt, Marinka; Cron, Randy Q; Tzaribachev, Nikolay; Guleria, Saurabh; von Kalle, Thekla; Koos, Bernd; Miller, Elka; Stimec, Jennifer; Vaid, Yoginder; Larheim, Tore A; Herlin, Troels; Spiegel, Lynn; Inarejos, Emilio; Moineddin, Rahim; van Rossum, Marion A; Saurenmann, Rotraud K; Doria, Andrea S; Kellenberger, Christian J (2018). Towards Establishing a Standardized Magnetic Resonance Imaging Scoring System for Temporomandibular Joints in Juvenile Idiopathic Arthritis. Arthritis Care & Research, 70(5):758-767.

Abstract

OBJECTIVES: The temporomandibular joints (TMJs) are frequently affected in children with juvenile idiopathic arthritis (JIA). Early detection is challenging, as major variation is present in scoring TMJ pathology on Magnetic Resonance Imaging (MRI). Consensus-driven development and validation of a MRI scoring system for TMJs has important clinical utility in timely improvement of diagnosis, and serving as an outcome measure. We report on a multi-institutional collaboration towards developing a TMJ MRI scoring system for JIA.
METHODS: Seven readers independently assessed MRI scans from 21 patients (42 TMJs, age range 6-16y) using three existing MRI scoring systems from American, German, and Swiss institutions. Reliability scores, scoring system definitions and items were discussed among 10 JIA experts through two rounds of Delphi surveys, nominal group voting, and subsequent consensus meetings to create a novel TMJ MRI scoring system.
RESULTS: Average-measure intraclass correlation coefficients (avICC) for the total scores of all three scoring systems were highly reliable at 0.96 each. Osteochondral items showed higher reliability than inflammatory items. An additive system was deemed preferable for assessing minor joint changes over time. Eight items were considered sufficiently reliable and/or important for integration into the consensus scoring system: bone marrow edema and enhancement (avICC=0.57-0.61; %SDD=±45-63% prior to re-defining), condylar flattening (0.95-0.96; ±23-28%), effusions (0.85-0.88; ±25-26%), erosions (0.94; ±20%), synovial enhancement and thickening (previously combined; 0.90-0.91; ±33%), and disk abnormalities (0.90; ±19%).
CONCLUSION: A novel TMJ MRI scoring system was developed by consensus. Further iterative refinements and reliability testing are warranted in upcoming studies.

Abstract

OBJECTIVES: The temporomandibular joints (TMJs) are frequently affected in children with juvenile idiopathic arthritis (JIA). Early detection is challenging, as major variation is present in scoring TMJ pathology on Magnetic Resonance Imaging (MRI). Consensus-driven development and validation of a MRI scoring system for TMJs has important clinical utility in timely improvement of diagnosis, and serving as an outcome measure. We report on a multi-institutional collaboration towards developing a TMJ MRI scoring system for JIA.
METHODS: Seven readers independently assessed MRI scans from 21 patients (42 TMJs, age range 6-16y) using three existing MRI scoring systems from American, German, and Swiss institutions. Reliability scores, scoring system definitions and items were discussed among 10 JIA experts through two rounds of Delphi surveys, nominal group voting, and subsequent consensus meetings to create a novel TMJ MRI scoring system.
RESULTS: Average-measure intraclass correlation coefficients (avICC) for the total scores of all three scoring systems were highly reliable at 0.96 each. Osteochondral items showed higher reliability than inflammatory items. An additive system was deemed preferable for assessing minor joint changes over time. Eight items were considered sufficiently reliable and/or important for integration into the consensus scoring system: bone marrow edema and enhancement (avICC=0.57-0.61; %SDD=±45-63% prior to re-defining), condylar flattening (0.95-0.96; ±23-28%), effusions (0.85-0.88; ±25-26%), erosions (0.94; ±20%), synovial enhancement and thickening (previously combined; 0.90-0.91; ±33%), and disk abnormalities (0.90; ±19%).
CONCLUSION: A novel TMJ MRI scoring system was developed by consensus. Further iterative refinements and reliability testing are warranted in upcoming studies.

Statistics

Citations

Dimensions.ai Metrics
2 citations in Web of Science®
1 citation in Scopus®
5 citations in Microsoft Academic
Google Scholar™

Altmetrics

Downloads

1 download since deposited on 15 Feb 2018
1 download since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Rheumatology
Language:English
Date:2018
Deposited On:15 Feb 2018 15:31
Last Modified:19 Aug 2018 14:02
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:2151-464X
Additional Information:This is the peer reviewed version of the following article: Tolend, M., Twilt, M., Cron, R., Tzaribachev, N., Guleria, S., Von Kalle, T., . . . Kellenberger, C. (2017). Towards Establishing a Standardized Magnetic Resonance Imaging Scoring System for Temporomandibular Joints in Juvenile Idiopathic Arthritis. Arthritis Care & Research, Arthritis care & research, 13 August 2017, which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1002/acr.23340/abstract. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
OA Status:Green
Publisher DOI:https://doi.org/10.1002/acr.23340
PubMed ID:28805021

Download

Download PDF  'Towards Establishing a Standardized Magnetic Resonance Imaging Scoring System for Temporomandibular Joints in Juvenile Idiopathic Arthritis'.
Preview
Content: Accepted Version
Language: English
Filetype: PDF
Size: 1MB
View at publisher