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Table 1 Comparison of radiographic progression scoring methods in psoriatic arthritis trials

From: Assessing structural damage progression in psoriatic arthritis and its role as an outcome in research

Scoring methodTotal joints, n (range of score)Locations (total joints, n)Damage score per jointAdditional features recorded
Modified Steinbrocker [12, 13]42 (0–168)Hands (28)
Wrists (2)
Feet (12)
0 = normal
1 = soft tissue swelling/osteopenia
2 = erosion
3 = erosion plus JSN
4 = total joint destruction
Typical modified Sharp used for PsA [4]Erosion, 54; JSN, 50 (erosion, 0–270; JSN, 0–200; total, 0–470)Hands (28)
Wrists (erosion, 14; JSN, 12)
Feet (erosion, 12; JSN, 10)
Erosion:
0 = no erosion
1 = 1 discrete erosion or < 21% of joint
2 = 2 erosions or 21–40% of joint
3 = 3 erosions or 41–60% of joint
4 = 4 erosions or 61–80% of joint
5 = extensive destruction, > 80% of joint
JSN:
0 = normal joint
1 = asymmetrical/minimal narrowing
2 = definite narrowing with loss of ≤ 50%
3 = definite narrowing with loss of 51–99%
4 = absence of joint space, ankylosis
Pencil in cup;
joint space widening
Sharp-van der Heijde for PsA [4]52 (erosion, 0–320; JSN, 0–208; total, 0–528)Hands (28)
Wrists (12)
Feet (12)
Erosion:
0 = no erosions
1 = discrete erosion
2 = large erosion not passing midline
3 = large erosion passing midline
Scores can be combined if > 1 erosion per joint is present for a maximum score of 5 per joint in the hands and 10 per joint in the feet
[Score of 5/10 if pencil-in-cup change or gross osteolysis present]
JSN:
0 = normal joint
1 = asymmetrical/minimal narrowing up to 25%
2 = definite narrowing with loss ≤ 50%
3 = definite narrowing with loss of 51–99% or subluxation
4 = absence of joint space, ankylosis, or complete luxation
[Score of 4 if pencil-in-cup change or gross osteolysis present]
Pencil in cup;
gross osteolysis
Psoriatic Arthritis Ratingen Score [14]40 (destruction, 0–200; proliferation, 0–160; total, 0–360)Hands (28)
Wrists (2)
Feet (10)
Destruction:
0 = normal
1 = ≥ 1 erosion, > 1 mm interruption of cortical plate, with up to 10% destruction of joint surface
2 = 11–25% destruction of joint surface
3 = 26–50% destruction of joint surface
4 = 51–75% destruction of joint surface
5 = > 75% joint surface destruction
Proliferation:
0 = normal
1 = bony proliferation of 1–2 mm or bone growth < 25% of original diameter
2 = bony proliferation 2–3 mm or bone growth of 25–50%
3 = bony proliferation > 3 mm or bone growth of > 50%
4 = bony ankylosis
  1. JSN joint space narrowing, PsA psoriatic arthritis
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