Table 1 Radiographic scoring system for new bone formation in gout
From: Development of a radiographic scoring system for new bone formation in gout
Sclerosis | |
Definition | Increased density of medullary or subcortical bone. |
Scoring rules | The proximal and distal bones are scored separately for interphalangeal joints, metacarpophalangeal joints, and metatarsophalangeal joints (maximum score for individual joint is 6). Single bones are scored for the carpal and tarsal articulations (maximum score for individual bone is 3). For long bones, score the 1-cm distance from the articular surface. If the bone is eroded, score the available bone as the denominator. |
Joints scored | The same bones scored in the gout-modified Sharp-van der Heijde scoring system for bone erosion (hand distal interphalangeal joints, hand proximal interphalangeal joints, interphalangeal joint of the thumb, metacarpophalangeal joints, base of the first metacarpal, multangular, scaphoid, lunate, radius, ulna, metatarsophalangeal joints, and interphalangeal joints of the hallux). |
Series and views | Hand: anterior-posterior. Foot: anterior-posterior. |
Score | 0 = no sclerosis. 1 = < 1/3 bone affected. 2 = 1/3-2/3 bone affected. 3 = > 2/3 bone affected. |
Total score range | 0–276. |
Spur | |
Definition | A sharp spicule of dense bone proliferation extending at an acute angle from the cortex. This should be differentiated from an osteophyte, which arises along the joint margin. |
Scoring rules | The proximal and distal bones are scored separately for interphalangeal joints, metacarpophalangeal joints, and metatarsophalangeal joints (maximum score for individual joint is 6). Single bones are scored for the carpal and tarsal articulations (maximum score for individual bone is 3). For long bones, score the 1-cm distance from the articular surface. |
Rules | The same bones scored in the gout-modified Sharp-van der Heijde scoring system for bone erosion (hand distal interphalangeal joints, hand proximal interphalangeal joints, interphalangeal joint of the thumb, metacarpophalangeal joints, base of the first metacarpal, multangular, scaphoid, lunate, radius, ulna, metatarsophalangeal joints, and interphalangeal joints of the hallux). |
Series and views | Hand: anterior-posterior and ball-catcher. Foot: anterior-posterior and oblique. |
Score | 0 = no spurs. 1 = 1 small spur. 2 = ≥ 2 small spurs and/or 1 moderate spur. 3 = ≥ 2 moderate spurs and/or ≥ 1 large spur(s). |
Total score range | 0–276. |