Radiological scoring in Psoriatic Arthritis

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Presentation transcript:

Radiological scoring in Psoriatic Arthritis Application of the OMERACT filter to four scoring methods

Radiological scoring methods for PsA Four methods described Modified Steinbrocker Ratingen method for PsA Sharp method for PsA Sharp/van der Heijde method for PsA All originally developed and tested for RA Addition of DIPs of the hands as a scoring site

Specific features in radiographs of PsA Joint pattern DIPs and PIPs, asymmetric and frequently in a ray-pattern Wrist and isolated ray Symmetrical as in RA Features Destruction (widening, osteolysis, pencil-in-cup) Proliferation (shaft metacarpal/tarsal, adjacent to joints, ankylosis)

Comparison of sites/features included in scoring modified Steinbrocker Ratingen Sharp Sharp/van der Heijde Films hands/feet Erosions JSN Malalignment Proliferation Global - X Range 0-160 0-360 0-470 0-528

Methods: OMERACT filter Truth : does the method measure what it should measure? Discrimination: Reliability, discrimination between patients, and sensitivity to change over time Feasibility Boers J Rheumatol 1998;25:198-9

Application in clinical trials Sharp and Sharp/van der Heijde method Proven sensitivity to change over short periods of time (24 – 52 weeks) Addition of DIPs of little extra value Trial duration too short to pick up change in pencil in cup, tuft resorption, periostitis, osteolysis

Plan for OMERACT 8 Scoring of the radiographs of IMPACT 1 by four different methods Involvement of developers of all methods Information on discrimintation Test-retest reliability Sensitivity to change Information on feasibility