{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:26:11Z","timestamp":1791973571843,"version":"4.4.0"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,4,12]],"date-time":"2018-04-12T00:00:00Z","timestamp":1523491200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100006126","name":"Hospital for Sick Children","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006126","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2018,5]]},"abstract":"Objective<\/jats:title>The temporomandibular joints (TMJ<\/jats:styled-content>s) are frequently affected in children with juvenile idiopathic arthritis (JIA<\/jats:styled-content>). Early detection is challenging, as major variation is present in scoring TMJ<\/jats:styled-content> pathology on magnetic resonance imaging (MRI<\/jats:styled-content>). Consensus\u2010driven development and validation of an MRI<\/jats:styled-content> scoring system for TMJ<\/jats:styled-content>s has important clinical utility in timely improvement of diagnosis and serving as an outcome measure. We report on a multi\u2010institutional collaboration toward developing a TMJ MRI<\/jats:styled-content> scoring system for JIA<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>Seven readers independently assessed MRI<\/jats:styled-content> scans from 21 patients (42 TMJ<\/jats:styled-content>s, from patients ages 6\u201316 years) using 3 existing MRI<\/jats:styled-content> scoring systems from American, German, and Swiss institutions. Reliability scores, scoring system definitions, and items were discussed among 10 JIA<\/jats:styled-content> experts through 2 rounds of Delphi surveys, nominal group voting, and subsequent consensus meetings to create a novel TMJ MRI<\/jats:styled-content> scoring system.<\/jats:p><\/jats:sec>Results<\/jats:title>Average\u2010measure absolute agreement intraclass correlation coefficients (avICC<\/jats:styled-content>s) for the total scores of all 3 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<\/jats:styled-content> 0.57\u20130.61, smallest detectable difference [SDD<\/jats:styled-content>] \u00b1 45\u201363% prior to redefining), condylar flattening (avICC<\/jats:styled-content> 0.95\u20130.96, SDD<\/jats:styled-content> \u00b1 23\u201328%), effusions (avICC<\/jats:styled-content> 0.85\u20130.88, SDD<\/jats:styled-content> \u00b1 25\u201326%), erosions (avICC<\/jats:styled-content> 0.94, SDD<\/jats:styled-content> \u00b1 20%), synovial enhancement and thickening (previously combined, avICC<\/jats:styled-content> 0.90\u20130.91, SDD<\/jats:styled-content> \u00b1 33%), and disk abnormalities (avICC<\/jats:styled-content> 0.90, SDD<\/jats:styled-content> \u00b1 19%).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>A novel TMJ MRI<\/jats:styled-content> scoring system was developed by consensus. Further iterative refinements and reliability testing are warranted in upcoming studies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23340","type":"journal-article","created":{"date-parts":[[2017,8,13]],"date-time":"2017-08-13T22:02:44Z","timestamp":1502661764000},"page":"758-767","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Toward Establishing a Standardized Magnetic Resonance Imaging Scoring System for Temporomandibular Joints in Juvenile Idiopathic Arthritis"],"prefix":"10.1002","volume":"70","author":[{"given":"Mirkamal A.","family":"Tolend","sequence":"first","affiliation":[{"name":"The Hospital for Sick Children Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marinka","family":"Twilt","sequence":"additional","affiliation":[{"name":"Alberta Children's Hospital Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randy Q.","family":"Cron","sequence":"additional","affiliation":[{"name":"Children's Hospital of Alabama Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolay","family":"Tzaribachev","sequence":"additional","affiliation":[{"name":"Pediatric Rheumatology Research Institute Bad Bramstedt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh","family":"Guleria","sequence":"additional","affiliation":[{"name":"Austin Radiological Association Austin Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thekla","family":"von Kalle","sequence":"additional","affiliation":[{"name":"Olgahospital Klinikum Stuttgart Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Koos","sequence":"additional","affiliation":[{"name":"University Hospital T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elka","family":"Miller","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Stimec","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoginder","family":"Vaid","sequence":"additional","affiliation":[{"name":"Children's Hospital of Alabama Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tore A.","family":"Larheim","sequence":"additional","affiliation":[{"name":"University of Oslo Blindern Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Troels","family":"Herlin","sequence":"additional","affiliation":[{"name":"Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"Spiegel","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio J.","family":"Inarejos Clemente","sequence":"additional","affiliation":[{"name":"Hospital Sant Joan de Deu Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahim","family":"Moineddin","sequence":"additional","affiliation":[{"name":"University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion A.","family":"van Rossum","sequence":"additional","affiliation":[{"name":"Emma Children's Hospital Academic Medical Centre, and Amsterdam Rheumatology and Immunology Center, Reade Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rotraud K.","family":"Saurenmann","sequence":"additional","affiliation":[{"name":"University Children's Hospital Z\u00fcrich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea S.","family":"Doria","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian J.","family":"Kellenberger","sequence":"additional","affiliation":[{"name":"University Children's Hospital Z\u00fcrich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,4,12]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"1520","article-title":"Worldwide prevalence of juvenile arthritis: why does it vary so much?","volume":"29","author":"Manners PJ","year":"2002","journal-title":"J Rheumatol"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sodo.2015.02.006"},{"key":"e_1_2_7_4_1","first-page":"1418","article-title":"Temporomandibular involvement in juvenile idiopathic arthritis","volume":"31","author":"Twilt M","year":"2004","journal-title":"J Rheumatol"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.12.10475"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23401"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.131337"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-207892"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kep068"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.160796"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00056-013-0166-8"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22177"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sodo.2015.02.007"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.166.3.8623619"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19980115)17:1<101::AID-SIM727>3.0.CO;2-E"},{"key":"e_1_2_7_16_1","first-page":"731","article-title":"Smallest detectable difference in radiological progression","volume":"26","author":"Lassere M","year":"1999","journal-title":"J Rheumatol"},{"key":"e_1_2_7_17_1","first-page":"1366","article-title":"OMERACT rheumatoid arthritis magnetic resonance imaging studies. Exercise 3: an international multicenter reliability study using the RA\u2010MRI score","volume":"30","author":"Lassere M","year":"2003","journal-title":"J Rheumatol"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-008-0025-6"},{"key":"e_1_2_7_19_1","first-page":"1157","article-title":"Intraarticular corticosteroid injections of the temporomandibular joint in juvenile idiopathic arthritis","volume":"35","author":"Ringold S","year":"2008","journal-title":"J Rheumatol"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.185.1.1523314"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0284185114548506"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes268"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.150308"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.141502"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11282-004-0014-z"}],"container-title":["Arthritis Care & Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Facr.23340","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.23340","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T15:49:47Z","timestamp":1759420187000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.23340"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,12]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1002\/acr.23340"],"URL":"https:\/\/doi.org\/10.1002\/acr.23340","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,12]]},"assertion":[{"value":"2016-10-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-08-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-04-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}