Evidence map›Paper›PMID 39814440›Full record

ArticleThe Journal of rheumatology2025

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

Adam Mayer, Timothy G Brandon, Amita Aggarwal, Ruben Burgos-Vargas, Robert A Colbert, Gerd Horneff, Rik Joos, Ronald M Laxer, Kirsten Minden, Angelo Ravelli and 19 more

Abstract readEvaluation StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors.

Adam MayerA. Mayer, MD, Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.ORCID 0000-0002-2646-0115
Timothy G BrandonT.G. Brandon, MPH, Department of Pediatrics, Division of Rheumatology and Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.ORCID 0000-0002-1305-4871
Amita AggarwalA. Aggarwal, MD, DM, Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.ORCID 0000-0002-2187-5186
Ruben Burgos-VargasR. Burgos-Vargas, MD, Department of Rheumatology, Hospital General de Mexico Dr Eduardo Ligeaga, Mexico City, Mexico.ORCID 0000-0003-1058-8955
Robert A ColbertR.A. Colbert, MD, PhD, National Institute of Arthritis, Musculoskeletal, and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA.ORCID 0000-0001-6237-4575
Gerd HorneffG. Horneff, MD, Department of General Paediatrics, Asklepios Klinik Sankt Augustin, Sankt Augustin, and Department of Pediatric and Adolescent Medicine, University Hospital Cologne, Cologne, Germany.
Rik JoosR. Joos, MD, University Hospital Gent, Ghent, and Department of Rheumatology, ZNA, Antwerp, Belgium.ORCID 0000-0002-6087-3861
Ronald M LaxerR.M. Laxer, MDCM, University of Toronto, The Hospital for Sick Children, and St. Michael's Hospital, Toronto, Ontario, Canada.
Kirsten MindenK. 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.ORCID 0000-0003-2775-0111
Angelo RavelliA. 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.ORCID 0000-0001-9658-0385
Nicolino RupertoN. Ruperto, MD, MPH, Università Milano Bicocca, Fondazione IRCCS San Gerardo dei Tintori, PRINTO, Monza, Italy.ORCID 0000-0001-8407-7782
Judith A SmithJ.A. Smith, MD, PhD, Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA.
Matthew L StollM.L. Stoll, MD, PhD, MSCS, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.ORCID 0000-0002-6225-3690
Shirley M TseS.M. Tse, MD, Department of Paediatrics, Division of Rheumatology, The Hospital for Sick Children (SickKids), University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-3027-7866
Filip Van den BoschF. Van den Bosch, MD, PhD, VIB-UGent Center for Inflammation Research, Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium.ORCID 0000-0002-3561-5932
Walter P MaksymowychW.P. Maksymowych, MD, Department of Medicine, University of Alberta, and CARE Arthritis, Edmonton, Alberta, Canada.ORCID 0000-0002-1291-1755
Robert G LambertR.G. Lambert, MB BCh, Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.ORCID 0000-0003-0305-3290
David M BikoD.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.
Nancy A ChauvinN.A. Chauvin, MD, Department of Radiology, Penn State Health Milton S. Hershey Children's Hospital, Hershey, Pennsylvania, USA.
Michael L FrancavillaM.L. Francavilla, MD, Department of Radiology, Whiddon College of Medicine, University of South Alabama, Mobile, Alabama, USA.ORCID 0000-0003-1347-7097
Jacob L JaremkoJ.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.ORCID 0000-0001-5314-2297
Nele HerregodsN. Herregods, MD, PhD, Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Belgium.ORCID 0000-0003-0244-0168
Ozgur KasapcopurO. Kasapcopur, MD, M. Yildiz, MD, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey.ORCID 0000-0002-1125-7720
Mehmet YildizO. Kasapcopur, MD, M. Yildiz, MD, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey.ORCID 0000-0002-7834-4909
Hemalatha SrinivasaluH. 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.ORCID 0000-0001-6714-4170
Jennifer A FaerberJ.A. Faerber, PhD, Data Science and Biostatistics Unit, Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Ray NadenR. Naden, MD, Departments of Medicine/Obstetric Medicine, Auckland City Hospital, Auckland, New Zealand, and McMaster University, Hamilton, Ontario, Canada.
Alison M HendryA.M. Hendry, General Medicine and Rheumatology, Division of Medicine, Counties Manukau District Health Board, Auckland, New Zealand.
Pamela F WeissP.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. weisspa@chop.edu.ORCID 0000-0002-9724-0443

Funding

Pathogenic Mechanisms in SpondyloarthritisZIAAR041184 · NIAMS · NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES · PI COLBERT, ROBERT · 2009 to 2025
$47.6M
TRAINING PROGRAM/RHEUMATIC DISEASEST32AR007442 · NIAMS · UNIVERSITY OF PENNSYLVANIA · PI BEHRENS, EDWARD M, MERKEL, PETER A · 1986 to 2018
$5.8M
Training Program/Rheumatic DiseasesT32AR076951 · NIAMS · UNIVERSITY OF PENNSYLVANIA · PI EDWARD M BEHRENS, Peter A Merkel · 2020 to 2026
$2.6M
Refining entry criteria and outcome measures for children with axial disease and spondyloarthritis: preparation for clinical trialsR01AR074098 · NIAMS · CHILDREN'S HOSP OF PHILADELPHIA · PI WEISS, PAMELA FITCH · 2019 to 2021
$678k
Mentoring and Patient Oriented Research in Juvenile SpondyloarthritisK24AR078950 · NIAMS · CHILDREN'S HOSP OF PHILADELPHIA · PI Pamela Fitch Weiss · 2022 to 2026
$664k
Intramural NIH HHS ZIA AR041184NIAMS NIH HHS K24 AR078950NIAMS NIH HHS R01 AR074098NIAMS NIH HHS T32 AR007442NIAMS NIH HHS T32 AR076951
6 · The paper itself

Abstract

objectiveTo evaluate the influence of pelvic magnetic resonance imaging (MRI) findings on axial disease assessment in juvenile spondyloarthritis (JSpA).

methodsThis was a cross-sectional study of patients with JSpA with suspected axial disease. Three experts reviewed each case and rated their confidence (-3 to +3) in the presence of axial disease, first with clinical data and second with clinical and MRI data. Agreement was defined as ≥ 2/3 clinical experts with a rating of ≤ -1 or ≥ 1, and high confidence agreement as ≤ -2 or ≥ 2. The association of clinical features and both global assessments was tested with modified Poisson regression models.

resultsTwo hundred seventy-two of 303 cases (89.8%) achieved agreement with clinical data alone. Adding imaging data affected agreement in 38.9% (118/303) and directionality of agreement in 23.4% (71/303). Agreement was facilitated in 26/31 cases and lost in 21/272 cases. Of those 71 cases that changed directionality, 33 changed from axial disease being absent to present and 38 from present to absent. The final model had an area under the receiver-operating characteristic (AUROC) curve of 0.93 and 3 factors were independently associated with expert agreement (HLA-B27: relative risk [RR] 1.41, 95% CI 1.14-1.74; pain improvement with activity: RR 1.27, 95% CI 1.05-1.54; and bone marrow edema on MRI: RR 4.08, 95% CI 2.91-5.73).

conclusionThe addition of imaging data affected directionality and improved high confidence agreement of expert assessment of axial disease. These results underscore the integral role of MRI in the determination of axial disease in JSpA.

Indexed as

Arthritis, JuvenileAxial SpondyloarthritisMagnetic Resonance ImagingPelvic BonesRisk AssessmentAdolescentArea Under CurveChildCross-Sectional StudiesFemaleHLA-B27 AntigenHumansInflammationMaleObserver VariationPoisson DistributionHLA-B27 Antigenmagnetic resonance imagingpediatricssacroiliitisspondyloarthropathy

Identifiers

PMID39814440
PMCPMC11788049

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.