Phornphutkul used a radiographic scoring system to monitor the degenerative arthritis that develops in patients with alkaptonuria. This can determine the severity of disease and the impact of therapeutic interventions over time. The authors are from National Institutes of Health, Armed Forces Institute of Pathology, University of Maryland and the Uniformed Services University of Health Sciences.
Subtotals:
(1) spine (cervical, thoracic lumbar)
(2) 12 large joints (hips, knees, shoulders, elbows, wrists, ankles) x (left, right)
Scoring Spinal Joints
|
Parameter |
Finding |
Points |
|
disk space narrowing |
none (normal) |
0 |
|
|
minimal |
1 |
|
|
substantial |
2 |
|
calcifications |
none (normal) |
0 |
|
|
mild |
1 |
|
|
marked |
2 |
score for each segment =
= (points for disk space narrowing) + (points for calcifications)
subtotal for spinal joints =
= SUM(points for all 3 segments)
Scoring Large Joints
|
Parameter |
Finding |
Points |
|
joint space |
no involvement |
0 |
|
|
minimal, with osteophytes, subchondral cysts or both, but no joint space narrowing |
1 |
|
|
mild, with minimal joint space narrowing |
2 |
|
|
moderate, with marked joint space narrowing |
3 |
|
|
severe, with bone-on-bone |
4 |
|
|
status post joint replacement |
4 |
|
joint calcification |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
extensive |
3 |
score for each joint =
= (points for joint space narrowing) + (points for calcifications)
subtotal for major joints =
= SUM(points for all 12 major joints)
total score =
= (subtotal for spinal joints) + (subtotal for major joints)
Interpretation:
• minimum scores: 0
• maximum score for each spinal segment: 4
• maximum subtotal for all 3 spinal segments: 12
• maximum score for each major joint: 7
• maximum subtotal for all 12 major joints: 84
• maximum total score: 96
• The higher the scores, the more severe the degenerative arthritis.
Specialty: Surgery, orthopedic, Immunology/Rheumatology
ICD-10: ,
