RT Journal Article
SR Electronic
T1 Development and Initial Validation of a Radiographic Scoring System for the Hip in Juvenile Idiopathic Arthritis
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.090691
DO 10.3899/jrheum.090691
A1 Marta Bertamino
A1 Federica Rossi
A1 Angela Pistorio
A1 Giorgio Lucigrai
A1 Maura Valle
A1 Stefania Viola
A1 Silvia Magni-Manzoni
A1 Clara Malattia
A1 Alberto Martini
A1 Angelo Ravelli
YR 2009
UL http://www.jrheum.org/content/early/2009/12/21/jrheum.090691.abstract
AB Objective To develop and validate a radiographic scoring system for the assessment of radiographic damage in the hip joint in patients with juvenile idiopathic arthritis (JIA). Methods The Childhood Arthritis Radiographic Score of the Hip (CARSH) assesses and scores these radiographic abnormalities: joint space narrowing (JSN), erosion, growth abnormalities, subchondral cysts, malalignment, sclerosis of the acetabulum, and avascular necrosis of the femoral head. Score validation was accomplished by evaluating reliability and correlational, construct, and predictive validity in 148 JIA patients with hip disease who had a total of 381 hip radiographs available for study. Results JSN was the most frequently observed radiographic abnormality, followed by erosion and sclerosis of the acetabulum. The least common abnormalities were avascular necrosis, growth abnormalities, and malalignment. Interobserver and intraobserver reliability on baseline and longitudinal score values and on score changes was good, with intraclass correlation coefficients ranging from 0.76 to 0.98. Early score changes, but not absolute baseline score values, were moderately correlated (rs > 0.4) with clinical indicators of disease damage at last followup observation, thereby demonstrating that the CARSH has good construct and predictive validity. The amount of structural damage in the hip radiograph at last followup observation was predicted better by baseline to 1-year score change (rs = 0.66; p < 0.0001) than by absolute baseline score values (rs = 0.40; p = 0.002). Conclusion Our results show that the CARSH is reliable and valid for the assessment of radiographic hip damage and its progression in patients with JIA.