Nuss et al developed a scale for grading joint damage seen on MRI in patients with hemophilic arthropathy. This scale is based on the most advanced degenerative abnormality. The authors are from the University of Colorado Health Sciences Center and the Childrens Hospital in Denver.
Parameters:
(1) effusion
(2) hemarthrosis
(3) synovial hyperplasia
(4) hemosiderin deposition
(5) subchondral cyst formation
(6) subchondral surface erosion
(7) percent loss of cartilage
|
Parameter |
Finding |
Points |
|
effusion |
none |
0 |
|
|
small |
1 |
|
|
moderate |
2 |
|
|
large |
3 |
|
hemarthrosis |
none |
0 |
|
|
small |
1 |
|
|
moderate |
2 |
|
|
large |
3 |
|
synovial hyperplasia |
none |
0 |
|
|
small |
4 |
|
|
moderate |
5 |
|
|
large |
6 |
|
hemosiderin deposition |
none |
0 |
|
|
small |
4 |
|
|
moderate |
5 |
|
|
large |
6 |
|
subchondral cyst formation |
0 |
0 |
|
|
1 |
7 |
|
|
2 or more |
8 |
|
subchondral surface erosion |
none |
0 |
|
|
partial |
7 |
|
|
full |
8 |
|
percent loss of cartilage |
0 |
0 |
|
|
< 50% |
9 |
|
|
>= 50% |
10 |
MRI scale value =
= MAX(points the 7 parameters)
Interpretation:
• A normal joint would have an MRI scale value of 0.
• The most severely affected joints show an MRI scale value of 10.
Limitations:
• There may be some interobserver variation, especially with interpreting small, moderate and large change. It is important to grade loss of cartilage accurately.
Specialty: Surgery, orthopedic
ICD-10: ,
