A team of Italian radiologists and rheumatologists have developed a simplified new radiographic scoring system for psoriatic arthritis, according to an article published online Dec. 7, 2018, in Skeletal Radiology.
Currently, one of three different scoring systems are used by radiologists to assess severity of joint damage in patients with psoriatic arthritis. These include the modified Sharp/van der Heijde Score (mSvdHS), the modfied Steinbroker global scoring method, and the Psoriatic Arthritis Ratingen Score (PARS). PARS is the only method that focuses on bony proliferation.
They Italian researchers developed their Simplified Psoriatic Arthritis Radiography Score (SPARS) system to assess destructive changes in a patient’s joints as well as osteoproliferation. SPARS assesses the grade of erosion of 40 joints in the hands and feet. The SPARS system totals the number of joints with erosions and the number with bony proliferations, for a total maximum possible score of 120.
The researchers validated the system with radiographs of 105 consecutive patients (71 women and 34 men) with inflammatory involvement in both their hands and feet, comparing their findings with scores of the mSvdHS and PARS systems. Their system produced comparable results with a high level of reliability among readers.
SPARS outperformed both systems with respect to the time needed to score the radiographs, with a range of 3.2 to 6.9 minutes, compared to 8.6 to 12.4 minutes for PARS, and 11.3 to 17.8 minutes for mSvdHS. The authors stated that this time-efficiency advantage would be beneficial in daily clinical use. They also pointed out that because so many joints are evaluated, there is less risk of underestimating articular damage.
The authors acknowledge that the SPARS system needs additional validation with larger sample sizes. They also recommend that future studies include various subgroups of patients and the possibility of comparing radiography with other imaging techniques.
New simplified psoriatic arthritis radiography score developed. Appl Radiol.