Conway et al developed a simple score for grading chest radiographs for a patient with cystic fibrosis. This is called the Northern system since it was developed by the North of England Cystic Fibrosis Units at Leeds, Birmingham, Manchester and Nottingham.
Parameters:
(1) severity of changes in the 4 lung quadrants on a posteroanterior (PA) chest radiograph
(2) overall assessment by the radiologist (gestalt view)
Lung quadrants used (using a horizontal line through the middle of the lung hila):
(1) left upper
(2) left lower
(3) right upper
(4) right lower
|
Severity of Disease |
Features in Each Quadrant |
Points |
|
normal (absent) |
no radiographic change |
0 |
|
mild |
faint linear markings and/or a few small nodular/cystic lesions <= 0.5 cm |
1 |
|
moderate |
linear markings prominent and/or nodular/cystic lesions > 0.5 cm and/or lesions more widespread |
2 |
|
severe |
areas of collapse and/or areas of consolidation and/or very prominent linear markings and/or profuse lesions |
3 |
|
extreme |
dense infiltrate with no normal lung |
4 |
|
Overall (Global) Severity |
Points |
|
normal |
0 |
|
mild |
1 |
|
moderate |
2 |
|
severe |
3 |
|
extreme |
4 |
total score =
= SUM(points for all 4 quadrants) + (points for global assessment)
Interpretation:
• minimum score: 0
• maximum score: 20
• The higher the score the more severe the pulmonary involvement.
Variation:
• The authors extended the score by including an evaluation of the lateral radiographs, but the method of scoring is not reported.
Performance:
• The score was found to be easy to use and reproducible.
• It compared favorably to other scoring systems (Chrispin-Norman, Brasfield, Schwachman-Kulczycki).
Specialty: Pulmonology, Genetics, Gastroenterology
ICD-10: ,
