Lequesne et al developed an index of severity for osteoarthritis for the hip (ISH). This can be used to assess the effectiveness of therapeutic interventions.
Sections for index:
(1) pain or discomfort
(2) maximum distance walked
(3) activities of daily living
I Pain or Discomfort
Parameter |
Finding |
Points |
pain or discomfort during nocturnal bedrest |
none |
0 |
|
only on movement or in certain positions |
1 |
|
without movement |
2 |
duration of morning stiffness or pain after getting up |
none |
0 |
|
< 15 minutes |
1 |
|
>= 15 minutes |
2 |
remaining standing for 30 minutes increases pain |
no |
0 |
|
yes |
1 |
pain on walking |
none |
0 |
|
only after walking some distance |
1 |
|
early after starting |
2 |
pain or discomfort in sitting position for 2 hours |
no |
0 |
|
yes |
1 |
where:
• A modification of a 1991 version was to have the duration of morning stiffness scored 0 if it was 1 minute or less and 1 if it was from 1 to less than 15 minutes.
• Pain on walking in a 1991 version expanded "early after starting" to "after initial ambulation and increasingly with continued ambulation"
II. Maximum Distance Walked
Parameter |
Finding |
Points |
maximum distance walked |
unlimited |
0 |
|
> 1 kilometer but limited |
1 |
|
about 1 kilometer (about 15 minutes) |
2 |
|
about 500 - 900 meters (about 8-15 minutes) |
3 |
|
from 300 - 500 meters |
4 |
|
from 100 - 300 meters |
5 |
|
< 100 meters |
6 |
walking aids required |
none |
0 |
|
1 walking stick or crutch |
1 |
|
2 walking sticks or crutches |
2 |
III. Activities of Daily Living
Parameter |
Finding |
Points |
Can you put on socks by bending forward? |
easily |
0 |
|
with mild difficulty |
0.5 |
|
with moderate difficulty |
1.0 |
|
with marked difficulty |
1.5 |
|
impossible |
2.0 |
Can you pick up an object from the floor? |
easily |
0 |
|
with mild difficulty |
0.5 |
|
with moderate difficulty |
1.0 |
|
with marked difficulty |
1.5 |
|
impossible |
2.0 |
Can you go up and down a standard flight of stairs? |
easily |
0 |
|
with mild difficulty |
0.5 |
|
with moderate difficulty |
1.0 |
|
with marked difficulty |
1.5 |
|
impossible |
2.0 |
Can you get into and out of a car? |
easily |
0 |
|
with mild difficulty |
0.5 |
|
with moderate difficulty |
1.0 |
|
with marked difficulty |
1.5 |
|
impossible |
2.0 |
index of severity =
= SUM(points for all parameters)
Interpretation:
• minimum points for each section: 0
• maximum points for each section: 8
Specialty: Surgery, orthopedic, Immunology/Rheumatology
ICD-10: ,