Tolend MA, et al. – The researchers intended to establish a temporomandibular joint (TMJs) magnetic resonance imaging (MRI) scoring system for juvenile idiopathic arthritis (JIA). They successfully developed a novel TMJ MRI scoring system by consensus. However, more likewise studies were required for iterative refinements and reliability testing.

Methods

• In this study, 7 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

• Findings revealed that average–measure intraclass correlation coefficients (avICC) for the total scores of all three scoring systems were highly reliable at 0.96 each.
• Osteochondral items displayed higher reliability than inflammatory items.
• An additive system was deemed preferable for assessing minor joint changes over time.
• 8 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%).