Effect of Characteristic Inflammatory and Structural Pelvic Magnetic Resonance Imaging Lesions on Expert Assessment of Axial Juvenile Spondyloarthritis

A. Mayer, MD, Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
T.G. Brandon, MPH, Department of Pediatrics, Division of Rheumatology and Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Department of Radiology, Whiddon College of Medicine, University of South Alabama, Mobile, Alabama, USA.
A. Aggarwal, MD, DM, Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
R. Burgos-Vargas, MD, Department of Rheumatology, Hospital General de Mexico Dr Eduardo Ligeaga, Mexico City, Mexico.
R.A. Colbert, MD, PhD, National Institute of Arthritis, Musculoskeletal, and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA.
G. Horneff, MD, Department of General Paediatrics, Asklepios Klinik Sankt Augustin, Sankt Augustin, and Department of Pediatric and Adolescent Medicine, University Hospital Cologne, Cologne, Germany.
R. Joos, MD, University Hospital Gent, Ghent, and Department of Rheumatology, ZNA, Antwerp, Belgium.
R.M. Laxer, MDCM, University of Toronto, The Hospital for Sick Children, and St. Michael's Hospital, Toronto, Ontario, Canada.
K. Minden, MD, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, and Deutsches Rheuma-Forschungszentrum Berlin, Berlin, Germany.
A. Ravelli, MD, Direzione Scientifica, IRCCS Istituto Giannina Gaslini, and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), Università degli Studi di Genova, Genoa, Italy.
N. Ruperto, MD, MPH, Università Milano Bicocca, Fondazione IRCCS San Gerardo dei Tintori, PRINTO, Monza, Italy.
J.A. Smith, MD, PhD, Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA.
M.L. Stoll, MD, PhD, MSCS, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
S.M. Tse, MD, Department of Paediatrics, Division of Rheumatology, The Hospital for Sick Children (SickKids), University of Toronto, Toronto, Ontario, Canada.
F. Van den Bosch, MD, PhD, VIB-UGent Center for Inflammation Research, Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium.
W.P. Maksymowych, MD, Department of Medicine, University of Alberta, and CARE Arthritis, Edmonton, Alberta, Canada.
R.G. Lambert, MB BCh, Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.
D.M. Biko, MD, Department of Radiology, Children's Hospital of Philadelphia and Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
N.A. Chauvin, MD, Department of Radiology, Penn State Health Milton S. Hershey Children's Hospital, Hershey, Pennsylvania, USA.
M.L. Francavilla, MD, Department of Radiology, Whiddon College of Medicine, University of South Alabama, Mobile, Alabama, USA.
J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.
N. Herregods, MD, PhD, Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Belgium.
O. Kasapcopur, MD, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey.
M. Yildiz, MD, Department of Pediatric Rheumatology, Istanbul University- Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey.
H. Srinivasalu, MD, Division of Rheumatology, Children's National Hospital, George Washington University School of Medicine, Washington, DC, and Pediatric Translational Research Branch, National Institute of Arthritis, Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA.
J.A. Faerber, PhD, Data Science and Biostatistics Unit, Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
R. Naden, MD, Departments of Medicine/Obstetric Medicine, Auckland City Hospital, Auckland, New Zealand, and McMaster University, Hamilton, Ontario, Canada.
A.M. Hendry, General Medicine and Rheumatology, Division of Medicine, Counties Manukau District Health Board, Auckland, New Zealand.
P.F. Weiss, MD, MSCE, Department of Pediatrics, Division of Rheumatology and Clinical Futures, Children's Hospital of Philadelphia and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Pennsylvania, USA.

R. Naden passed away on August 16, 2020.
ACKNOWLEDGMENT: The authors thank Joel Paschke (CARE Arthritis) for preparing the imaging review modules, and the following collaborators for their contributions of patient clinical data and MRI scans: Matthew Stoll (University ofAlabama- Birmingham), Gerd Horneff (Asklepios Clinic Sankt Augustin), Giulia Armaroli (Asklepios Clinic Sankt Augustin), Ariane Klein (Asklepios Clinic Sankt Augustin), Rebekka Heidebrecht (Asklepios Clinic Sankt Augustin), Hemalatha Srinivasalu (NIH/NIAMS and Children's National Hospital), Manuk Manukyan (NIH/NIAMS), Judith A. Smith (University of Wisconsin-Madison), Thomas P. Callaci (University of Wisconsin-Madison), and John W. Garrett (University of Wisconsin-Madison).
CONTRIBUTIONS: Conceptualization, writing - original draft, writing - review & editing: AM; writing - original draft, writing - review & editing, formal analysis, data curation, Project administration: TGB; investigation, writing - review & editing, resources, data curation: RAC, GH, MLS; investigation, writing - review & editing: AA, RBV, RJ, RML, KM, AR, NR, JAS, SMT, FVdB, WPM, RGL, DMB, NAC, MLF, JLJ, NH; writing - review & editing, resources, data curation: OK, MY, HS; writing - review & editing, formal analysis, data curation: JAF; investigation, methodology: RN; investigation, writing - review & editing, methodology: AMH; conceptualization, funding acquisition, writing - original draft, methodology, writing - review & editing, formal analysis, supervision, investigation, resources, project administration, data curation: PFW.
FUNDING: Support for the project was provided by the National Institutes of Health (NIH) National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) T-32-AR007442 (to AM), NIH NIAMS K24AR078950 (to PFW), NIH NIAMS R01AR074098 (to PFW), and NIAMS Intramural Research Program ZIA AR041184 (to RAC).
CONFLICTS OF INTEREST: PFW has received royalties/licenses from UpToDate (< $10,000 to author); consulting fees as a site investigator for Pfizer and AbbVie Clinical Trials (to institution); advisory board member fees for Lilly and Novartis (both < $10,000 to author); consulting fees from Pfizer (to institution); and speaker fees or honoraria from RheumNow 2022 for being a speaker (< $5000 to author) and the Spondyloarthritis Research and Treatment Network for educational materials (< $5000 to author). RAC has held leadership or fiduciary roles for the Childhood Arthritis and Rheumatology Research Alliance (CARRA). RML has received consulting fees (< $5000 to author) from Novartis, Sanofi, Eli Lilly, Akros, and Alexion; and royalties/licenses from UpToDate (< $10,000 to author). KM has received speaker fees or honoraria from Novartis, Pfizer, and Medac. RGL has received consulting fees from AbbVie and CARE Arthritis, Image Analysis Group. OK has received speaker fees or honoraria from Novartis, AbbVie, Pfizer, Roche, Sanofi, Amgen; and held a leadership and fiduciary role as Chairman of the Turkish Pediatric Association. FVdB has received consulting fees from AbbVie, Celgene, Eli Lilly, Galapagos, Janssen, Moonlake, Novartis, Pfizer, and UCB. WPM has held leadership and fiduciary roles as a Board of Directors member of SPARTAN; has other financial or nonfinancial interests as Chief Medical Officer for CARE Arthritis; and has received consulting fees from AbbVie, BMS, Celgene, Eli Lilly, Galapagos, Novartis, Pfizer, and UCB; speaker fees from AbbVie, Novartis, Janssen, Pfizer, and UCB; and grants from AbbVie, BMS, Eli Lilly, Novartis, Pfizer, and UCB. GH has received speaker fees or honoraria from Novartis, MSD, Pfizer, Roche, Sanofi, Sobi, and Biogen. HS has received speaker fees or honoraria from Pfizer (< $5000 to author), the NIH Intramural Research Program, and as a CARRA Registry Associate. The remaining authors declare no conflicts of interest relevant to this article.
ETHICS AND PATIENT CONSENT: This study was reviewed by the Children's Hospital of Philadelphia Institutional Review Board (IRB) and the IRB determined the procedures met the exemption criteria per 45 CFR 46.104(d) 4(iii). Consent was not required for this study (IRB 19-016078).
Accepted for publication November 11, 2024.

Address correspondence to Dr. P.F. Weiss, Children's Hospital of Philadelphia, 2716 South Street, 11th floor 11123 Philadelphia, PA 19146, USA. Email: weisspa@chop.edu.