Backhaus et al reported a scoring system for a joint assessment performed using ultrasound. This involved assessments for synovitis, tenosynovitis or paratendonitis, and erosions. The authors are from multiple hospitals in Germany.
Evaluation was performed with gray-scale ultrasound (GSUS) or power Doppler ultrasound (PDUS).
Sites selected: clinically dominant hand and foot
Joint locations assessed for synovitis using PDUS: 13 sites over 7 joints
Fingers:
(1) metacarpophalangeal (MCP) II, dorsal aspect
(2) metacarpophalangeal (MCP) II, palmar aspect
(3) metacarpophalangeal (MCP) III, dorsal aspect
(4) metacarpophalangeal (MCP) III, palmar aspect
(5) proximal interphalangeal (PIP) II, dorsal aspect
(6) proximal interphalangeal (PIP) II, palmar aspect
(7) proximal interphalangeal (PIP) III, dorsal aspect
(8) proximal interphalangeal (PIP) III, palmar aspect
Wrist:
(1) dorsal
(2) palmar
(3) ulnar
Toes
(1) metatarsophalangeal (MTP) II, dorsal aspect
(2) metatarsophalangeal (MTP) V, dorsal aspect
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Changes on PDUS
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Grade
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no intra-articular color signal
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0
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up to 3 color signals OR (2 single and 1 confluent signal in the intra-articular area)
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1
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more than Grade 1 AND < 50% of intra-articular area filled with color signals
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2
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>= 50% of intra-articular area filled with color signals
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3
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total score for synovitis on one side =
= SUM(points for all 13 sites)
Interpretation:
• minimum score on PDUS: 0
• maximum score on PDUS: 39
