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 GSUS: 9 sites over 7 joints
Fingers:
(1) metacarpophalangeal (MCP) II, palmar aspect
(2) metacarpophalangeal (MCP) III, palmar aspect
(3) proximal interphalangeal (PIP) II, palmar aspect
(4) 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 GSUS
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Grade
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none
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0
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mild (small hypoechoic or anechoic line beneath joint capsule)
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1
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moderate (joint capsule elevated parallel to the joint area)
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2
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severe (significant distention of the joint capsule)
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3
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total score for synovitis on one side =
= SUM(points for all 9 sites)
Interpretation:
• minimum score on GSUS: 0
• maximum score on GSUS: 27
