Ultrasonographic semiquantitative joint-specific scoring system for BM in juvenile idiopathic arthritis
| Joint | Semiquantitative scoring system, BM |
| Anterior elbow | 0: No or minimal synovial hypertrophy/effusion 1: Mild synovial hypertrophy/effusion 2: Moderate synovial hypertrophy/effusion up to, but not beyond the imaginary line* 3: Severe synovial hypertrophy/effusion beyond the imaginary line* and a clearly convex shape * The line above the radial fossa; between the proximal end of the fossa to the top of the cartilage over the capitulum humeri |
| Posterior elbow | 0: No or minimal synovial hypertrophy/effusion 1: Mild synovial hypertrophy/effusion, filling up to 25% of the fossa 2: Moderate synovial hypertrophy/effusion filling up to 50% of the fossa, but not beyond the imaginary line* 3: Severe synovial hypertrophy/effusion filling more than 50% of the fossa and/or extending beyond the imaginary line* * The line above the fossa olecrani; between the proximal end of the fossa to the top of the cartilage of the trochlea humeri |
| Radiocarpal and midcarpal | 0: No sign of synovial hypertrophy/effusion 1: Mild synovial hypertrophy/effusion 2: Moderate synovial hypertrophy/effusion up to, but not beyond the imaginary line* 3: Severe synovial hypertrophy/effusion with a convex shape extending beyond the imaginary line* and can push up the extensor tendons * The line between the top of the cartilage of the distal end of the radius to the top of the cartilage of the capitate (just proximal to the CMC joint) |
| MCP2–3, dorsal | 0: No sign of synovial hypertrophy/effusion 1: Mild synovial hypertrophy/effusion but not beyond the imaginary line* 2: Moderate synovial hypertrophy/effusion extending beyond the imaginary line*, but without overall convex shape 3: Severe synovial hypertrophy/effusion extending beyond the imaginary line* with a clearly convex shape * The line between the top of the cartilage of the distal end of the metacarpal to the top of the cartilage of the proximal end of the phalanx |
| PIP2–3, dorsal | 0: No sign of synovial hypertrophy/effusion 1: Mild synovial hypertrophy/effusion but not beyond the imaginary line* 2: Moderate synovial hypertrophy/effusion extending beyond the imaginary line*, but without overall convex shape 3: Severe synovial hypertrophy/effusion extending beyond the imaginary line* with a clearly convex shape *The line between the top of the cartilage of the distal end of the proximal phalanx to the top of the cartilage of the proximal end of the middle phalanx |
| PIP2–3, volar | 0: No sign of synovial hypertrophy/effusion 1: Mild synovial hypertrophy/effusion, possible to extend proximally but without convex shape 2: Moderate synovial hypertrophy/effusion extending over the proximal phalanx with convex shape, but not filling the joint space between proximal and middle phalanx 3: Severe synovial hypertrophy/effusion extending over the proximal phalanx and filling the joint space between proximal and middle phalanx with an overall convex shape |
| Hip | 0: No sign of synovial hypertrophy/effusion 1: Mild synovial hypertrophy/effusion, but just a ‘slit’ of fluid between the two layers of the capsule 2: Moderate synovial hypertrophy/effusion leading to a straight line/minimal convex shape of the capsule 3: Severe synovial hypertrophy/effusion with a clearly convex shape, the effusion can also extend proximally over the femoral head |
| Knee, suprapatellar recess | 0: ‘Slit’ of fluid/synovium without elevation of the prepatellar fat pad but with only minimal extension beyond the prepatellar fat pad 1: Mild synovial hypertrophy/effusion with elevation of the prepatellar fat pad and extension proximally <50% of the visualised portion of the quadriceps tendon 2: Moderate synovial hypertrophy/effusion elevating the prepatellar fat pad with extension proximally >50% of the visualised portion of the quadriceps tendon 3: Significant distension of the suprapatellar recess throughout the image, and with the most proximal portion of the synovial recess being >50% of the maximum distension of the recess 17 |
| Knee, lateral parapatellar recess | 0: Empty parapatellar recess but a minimal bulge of synovial hypertrophy/effusion may be found extending to the patellofemoral joint line 1: Synovial hypertrophy/effusion filling <1/3 of the full area of the parapatellar recess 2: Synovial hypertrophy/effusion filing between 1/3 to 2/3 of the full area of the parapatellar recess 3: Synovial hypertrophy/effusion that fills >2/3 of the full area of the parapatellar recess and clearly pushing up the retinaculum 17 |
| Tibiotalar | 0: No sign of synovial hypertrophy/effusion in the tibiotalar joint, but possible to have a minimal amount of fluid in the concave neck of the talus 1: Mild synovial hypertrophy/effusion filling the gap between the tibia and the talus and in the concave neck of the talus, but not continuously over the talus 2: Moderate synovial hypertrophy/effusion filling <50% of the area between the tibia, the talus and the imaginary line* and continuously over the talus 3: Severe synovial hypertrophy/effusion filling >50% of the area between the tibia, the talus and the imaginary line* or beyond the imaginary line* * The line between the top of the cartilage of the distal end of the tibia and the top of the cartilage of the talar head |
| Talonavicular | 0: No sign of synovial hypertrophy/effusion 1: Mild synovial hypertrophy/effusion but not beyond the imaginary line* 2: Moderate synovial hypertrophy/effusion extending beyond the imaginary line* and proximal with a concave or straight shape 3: Severe synovial hypertrophy/effusion extending beyond the imaginary line* and over the talus with a convex shape clearly pushing up the joint capsule * The line between the top of the cartilage of the head of the talus to the top of the cartilage of the navicular bone |
| Anterior subtalar | 0: No sign of synovial hypertrophy/effusion 1: Mild synovial hypertrophy/effusion covering up to 25% of the straight part of the talus 2: Moderate synovial hypertrophy/effusion covering up to 50% of the straight part of the talus 3: Severe synovial hypertrophy/effusion covering more than 50% of the straight part of the talus |
| Posterior subtalar | 0: No sign of synovial hypertrophy/effusion 1: Mild synovial hypertrophy/effusion filling the gap between the talus and the calcaneus 2: Moderate synovial hypertrophy/effusion extending beyond the talus and the calcaneus but not with a convex shape 3: Severe synovial hypertrophy/effusion extending beyond the talus and the calcaneus with a convex shape |
| MTP2–3 dorsal | 0: No sign of synovial hypertrophy/effusion 1: Mild synovial hypertrophy/effusion but not beyond the imaginary line* 2: Moderate synovial hypertrophy/effusion extending beyond the imaginary line*, but without overall convex shape 3: Severe synovial hypertrophy/effusion extending beyond the imaginary line* with a clearly convex shape * The line between the top of the cartilage of the distal end of the metatarsal to the top of the cartilage of the proximal end of the phalanx |
BM, B-mode; CMC, carpometacarpal; MCP, metacarpophalangeal; MTP, metatarsophalangeal; PIP, proximal interphalangeal.