Systemic sclerosis may affect internal organs in addition to the skin. Medsger et al developed severity scales to grade severity of end-organ damage in affected organs. The authors are from multiple universities in North America and Europe.
Parameters:
(1) fingertip-to-palm distance with finger at maximal flexion, in cm
(2) proximal muscle weakness
(3) need for ambulation aid
Joint Severity Scale
Fingertip-to-Palm
GSS Grade
< 1 cm
0 (normal)
1 to 1.9 cm
1 (mild)
2 to 3.9 cm
2 (moderate)
4 to 4.9 cm
3 (severe
>= 5 cm
4 (endstage)
Muscle Severity Scale (MSS)
Proximal Muscle Weakness
Ambulation Aids
GSS Grade
normal
not needed
0 (normal)
mild
not needed
1 (mild)
moderate
not needed
2 (moderate)
severe
not needed
3 (severe
severe
needed
4 (endstage)
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