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Radiographic scoring methods in rheumatoid arthritis and psoriatic arthritis

  • MUSCULOSKELETAL RADIOLOGY
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Abstract

Structural changes of bone and cartilage are the hallmarks of rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Radiography can help in making diagnosis and in differentiating PsA and RA from other articular diseases. Radiography is still considered the preferred imaging method to assess disease progression, reflecting cumulative damage over time. The presence of bone erosions in RA is as an indicator of irreversible articular damage. Radiographic features of PsA are characteristic and differ from those observed in RA, especially in the distribution of affected joints and in the presence of destructive changes and bone proliferation at the same time. Semiquantitative scoring methods are designed to measure the degree of radiographically detectable joint damage and of changes over time. Several radiographic scoring methods that had been developed originally for RA have been adopted for the use in PsA. This review discusses the use of conventional radiography for diagnosing and detecting early structural changes in RA and PsA and providing a historical overview of commonly used scoring methods.

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References

  1. Salaffi F, De Angelis R, Grassi W, MArche Pain Prevalence, INvestigation Group (MAPPING) study (2005) Prevalence of musculoskeletal conditions in an Italian population sample: results of a regional community-based study. I. The MAPPING study. Clin Exp Rheumatol 23:819–828

    CAS  PubMed  Google Scholar 

  2. Hazes JMW, Luime JJ (2011) The epidemiology of early inflammatory arthritis. Nat Rev Rheumatol 7:381–390. https://doi.org/10.1038/nrrheum.2011.78

    Article  PubMed  Google Scholar 

  3. Scott DL, Coulton BL, Symmons DPM, Popert AJ (1987) Long-term outcome of treating rheumatoid arthritis: results after 20 years. Lancet 1:1108–1111. https://doi.org/10.1016/S0140-6736(87)91672-2

    Article  CAS  PubMed  Google Scholar 

  4. Plant MJ, Jones PW, Saklatvala J et al (1998) Patterns of radiological progression in early rheumatoid arthritis: results of an 8 year prospective study. J Rheumatol 25:417–426

    CAS  PubMed  Google Scholar 

  5. Gladman DD, Stafford-Brady F, Chang CH et al (1990) Longitudinal study of clinical and radiological progression in psoriatic arthritis. J Rheumatol 17:809–812

    CAS  PubMed  Google Scholar 

  6. Kasturi S, Goldstein BL, Malspeis S et al (2014) Comparison of the 1987 American College of Rheumatology and the 2010 American College of Rheumatology/European League against Rheumatism criteria for classification of rheumatoid arthritis in the Nurses’ Health Study cohorts. Rheumatol Int 34:407–411. https://doi.org/10.1007/s00296-013-2865-2

    Article  PubMed  Google Scholar 

  7. Taylor W, Gladman D, Helliwell P et al (2006) Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 54:2665–2673. https://doi.org/10.1002/art.21972

    Article  PubMed  Google Scholar 

  8. Welsing PMJ, Landewé RBM, Van Riel PLCM et al (2004) The relationship between disease activity and radiologic progression in patients with rheumatoid arthritis: a longitudinal analysis. Arthritis Rheum 50:2082–2093. https://doi.org/10.1002/art.20350

    Article  PubMed  Google Scholar 

  9. Pincus T, Ferraccioli G, Sokka T et al (2002) Evidence from clinical trials and long-term observational studies that disease-modifying anti-rheumatic drugs slow radiographic progression in rheumatoid arthritis: updating a 1983 review. Rheumatology 41:1346–1356. https://doi.org/10.1093/rheumatology/41.12.1346

    Article  CAS  PubMed  Google Scholar 

  10. Smolen JS, Landewé R, Bijlsma J et al (2017) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Ann Rheum Dis 76:960–977

    Article  PubMed  Google Scholar 

  11. Fuchs HA, Kaye JJ, Callahan LF et al (1989) Evidence of significant radiographic damage in rheumatoid arthritis within the first 2 years of disease. J Rheumatol 16:585–591. https://doi.org/10.1152/advan.00069.2007

    Article  CAS  PubMed  Google Scholar 

  12. Van der Heijde DMFM, Van Leeuwen MA, Van Riel PLCM, Van de Putte LBA (1995) Radiographic progression on radiographs of hands and feet during the first 3 years of rheumatoid arthritis measured according to Sharp’s method (van der Heijde modification). J Rheumatol 22:1792–1796

    PubMed  Google Scholar 

  13. Combe B, Cantagrel A, Goupille P et al (2003) Predictive factors of 5-year health assessment questionnaire disability in early rheumatoid arthritis. J Rheumatol 30:2344–2349. https://doi.org/10.1109/TIE.2007.909736

    Article  PubMed  Google Scholar 

  14. Salaffi F, Ferraccioli G, Peroni M et al (1994) Progression of erosion and joint space narrowing scores in rheumatoid arthritis assessed by nonlinear models. J Rheumatol 21:1626–1630

    CAS  PubMed  Google Scholar 

  15. Gremese E, Salaffi F, Bosello SL et al (2013) Very early rheumatoid arthritis as a predictor of remission: a multicentre real life prospective study. Ann Rheum Dis 72:858–862. https://doi.org/10.1136/annrheumdis-2012-201456

    Article  PubMed  Google Scholar 

  16. Soubrier M, Lukas C, Sibilia J et al (2011) Disease activity score-driven therapy versus routine care in patients with recent-onset active rheumatoid arthritis: data from the GUEPARD trial and ESPOIR cohort. Ann Rheum Dis 70:611–615. https://doi.org/10.1136/ard.2010.137695

    Article  CAS  PubMed  Google Scholar 

  17. Smolen JS, Van Der Heijde DM, Keystone EC et al (2013) Association of joint space narrowing with impairment of physical function and work ability in patients with early rheumatoid arthritis: protection beyond disease control by adalimumab plus methotrexate. Ann Rheum Dis 72:1156–1162. https://doi.org/10.1136/annrheumdis-2012-201620

    Article  CAS  PubMed  Google Scholar 

  18. Landewé RBM, Connell CA, Bradley JD et al (2016) Is radiographic progression in modern rheumatoid arthritis trials still a robust outcome? Experience from tofacitinib clinical trials. Arthritis Res Ther 18:212. https://doi.org/10.1186/s13075-016-1106-y

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Vastesaeger N, Xu S, Aletaha D et al (2009) A pilot risk model for the prediction of rapid radiographic progression in rheumatoid arthritis. Rheumatology 48:1114–1121. https://doi.org/10.1093/rheumatology/kep155

    Article  CAS  PubMed  Google Scholar 

  20. Jones G, Halbert J, Crotty M et al (2003) The effect of treatment on radiological progression in rheumatoid arthritis: a systematic review of randomized placebo-controlled trials. Rheumatology 42:6–13. https://doi.org/10.1093/rheumatology/keg036

    Article  CAS  PubMed  Google Scholar 

  21. Schett G, Coates LC, Ash ZR et al (2011) Structural damage in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: traditional views, novel insights gained from TNF blockade, and concepts for the future. Arthritis Res Ther 13:S4. https://doi.org/10.1186/1478-6354-13-S1-S4

    Article  PubMed  PubMed Central  Google Scholar 

  22. Finckh A, Liang MH, Van Herckenrode CM, De Pablo P (2006) Long-term impact of early treatment on radiographic progression in rheumatoid arthritis: a meta-analysis. Arthritis Care Res 55:864–872. https://doi.org/10.1002/art.22353

    Article  Google Scholar 

  23. Korpela M, Laasonen L, Hannonen P et al (2004) Retardation of joint damage in patients with early rheumatoid arthritis by initial aggressive treatment with disease-modifying antirheumatic drugs: five-year experience from the FIN-RACo study. Arthritis Rheum 50:2072–2081. https://doi.org/10.1002/art.20351

    Article  CAS  PubMed  Google Scholar 

  24. Helliwell PS, Porter G, Taylor WJ (2007) Polyarticular psoriatic arthritis is more like oligoarticular psoriatic arthritis, than rheumatoid arthritis. Ann Rheum Dis 66:113–117. https://doi.org/10.1136/ard.2006.054288

    Article  CAS  PubMed  Google Scholar 

  25. Kruithof E, Baeten D, De Rycke L et al (2005) Synovial histopathology of psoriatic arthritis, both oligo- and polyarticular, resembles spondyloarthropathy more than it does rheumatoid arthritis. Arthritis Res Ther 7:R569–R580. https://doi.org/10.1186/ar1698

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Salaffi F, Di Carlo M, Luchetti MM et al (2018) A validation study of the Simple Psoriatic Arthritis Screening (SiPAS) questionnaire to screen psoriasis patients for psoriatic arthritis. Clin Exp Rheumatol 36:127–135

    PubMed  Google Scholar 

  27. Simon P, Pföhler C, Bergner R et al (2012) Swollen joint count in psoriatic arthritis is associated with progressive radiological damage in hands and feet. Clin Exp Rheumatol 30:45–50. https://doi.org/10.1016/j.tetlet.2012.02.016

    Article  CAS  PubMed  Google Scholar 

  28. Kane D, Stafford L, Bresniham B, FitzGerard O (2003) A prospective, clinical and radiological study of early psoriatic arthritis: an early synovitis clinic experience. Rheumatology 42:1460–1468. https://doi.org/10.1093/rheumatology/keg384

    Article  CAS  PubMed  Google Scholar 

  29. Brown AK (2013) How to interpret plain radiographs in clinical practice. Best Pract Res Clin Rheumatol 27:249–269. https://doi.org/10.1016/j.berh.2013.03.004

    Article  PubMed  Google Scholar 

  30. Carotti M Salaffi F Di Carlo M Sessa F Giovagnoni A (2018) Magnetic resonance imaging of the craniovertebral junction in early rheumatoid arthritis. Skelet Radiol Epub ahead: https://doi.org/10.1007/s00256-018-3055-9

    Article  PubMed  Google Scholar 

  31. Llopis E, Kroon HM, Acosta J, Bloem JL (2017) Conventional radiology in rheumatoid arthritis. Radiol Clin N Am 55:917–941. https://doi.org/10.1016/j.rcl.2017.04.002

    Article  PubMed  Google Scholar 

  32. Brown JH, Deluca SA (1995) The radiology of rheumatoid arthritis. Am Fam Physician 52:1372–1380

    CAS  PubMed  Google Scholar 

  33. Sankowski AJ, Lebkowska UM, Cwikła J et al (2013) Psoriatic arthritis. Pol J Radiol 78:7–17. https://doi.org/10.12659/PJR.883763

    Article  PubMed  PubMed Central  Google Scholar 

  34. Scott DL, Coulton BL, Popert AJ (1986) Long term progression of joint damage in rheumatoid arthritis. Ann Rheum Dis 45:373–378. https://doi.org/10.1136/ard.45.5.373

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Möttönen TT (1988) Prediction of erosiveness and rate of development of new erosions in early rheumatoid arthritis. Ann Rheum Dis 47:648–653. https://doi.org/10.1136/ard.47.8.648

    Article  PubMed  PubMed Central  Google Scholar 

  36. Der Heijde DMFMV, Leeuwen MAV, Riel PLCMV et al (1992) Biannual radiographic assessments of hands and feet in a three-year prospective followup of patients with early rheumatoid arthritis. Arthritis Rheum 35:26–34. https://doi.org/10.1002/art.1780350105

    Article  Google Scholar 

  37. Ory PA (2003) Interpreting radiographic data in rheumatoid arthritis. Ann Rheum Dis 62:597–604. https://doi.org/10.1136/ard.62.7.597

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Boini S, Guillemin F (2001) Radiographic scoring methods as outcome measures in rheumatoid arthritis: properties and advantages. Ann Rheum Dis 60:817–827

    CAS  PubMed  PubMed Central  Google Scholar 

  39. Larsen A, Dale K, Eek M (1977) Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Ser Diagn 18:481–491. https://doi.org/10.1177/028418517701800415

    Article  CAS  Google Scholar 

  40. Scott DL, Laasonen L, Priolo F et al (1997) The radiological assessment of rheumatoid arthritis. Clin Exp Rheumatol 15:S53–S61

    PubMed  Google Scholar 

  41. Van Der Heijde D (2000) How to read radiographs according to the Sharp/van der Heijde method. J Rheumatol 27:261–263. https://doi.org/10.1093/rheumatology/keq334

    Article  PubMed  Google Scholar 

  42. Salaffi F, Carotti M, Ciapetti A et al (2011) Relationship between time-integrated disease activity estimated by DAS28-CRP and radiographic progression of anatomical damage in patients with early rheumatoid arthritis. BMC Musculoskelet Disord 12:120. https://doi.org/10.1186/1471-2474-12-120

    Article  PubMed  PubMed Central  Google Scholar 

  43. Salaffi F, Carotti M, Lamanna G, Baldelli S (1997) Quantitative analysis of radiologic progression in rheumatoid arthritis: controversies and perspectives. Radiol Med 93:174–184

    CAS  PubMed  Google Scholar 

  44. Sharp JT, Lidsky MD, Collins LC, Moreland J (1971) Methods of scoring the progression of radiologic changes in rheumatoid arthritis. Correlation of radiologic, clinical and laboratory abnormalities. Arthritis Rheum 14:706–720. https://doi.org/10.1002/art.1780140605

    Article  CAS  PubMed  Google Scholar 

  45. Sharp JT, Young DY, Bluhm GB et al (1985) How many joints in the hands and wrists should be included in a score of radiologic abnormalities used to assess rheumatoid arthritis? Arthritis Rheum 28:1326–1335. https://doi.org/10.1002/art.1780281203

    Article  CAS  PubMed  Google Scholar 

  46. Larsen A (1995) How to apply Larsen score in evaluating radiographs of rheumatoid arthritis in longterm studies? J Rheumatol 22:1974–1975

    CAS  PubMed  Google Scholar 

  47. Kaye JJ, Callahan LF, Nance EP et al (1987) Rheumatoid arthritis: explanatory power of specific radiographic findings for patient clinical status. Radiology 165:753–758. https://doi.org/10.1148/radiology.165.3.3685355

    Article  CAS  PubMed  Google Scholar 

  48. Genant HK (1983) Methods of assessing radiographic change in rheumatoid arthritis. Am J Med 75:35–47. https://doi.org/10.1016/0002-9343(83)90473-4

    Article  CAS  PubMed  Google Scholar 

  49. Van Der Heijde DM, Van Riel PL, Gribnau FW et al (1989) Effects of hydroxychloroquine and sulphasalazine on progression of joint damage in rheumatoid arthritis. Lancet 1:1036–1038. https://doi.org/10.1016/S0140-6736(89)92442-2

    Article  PubMed  Google Scholar 

  50. Smolen JS, Landewé R, Bijlsma J et al (2017) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Ann Rheum Dis 76:960–977. https://doi.org/10.1136/annrheumdis-2016-210715

    Article  PubMed  Google Scholar 

  51. Combe B, Landewe R, Daien CI et al (2017) 2016 update of the EULAR recommendations for the management of early arthritis. Ann Rheum Dis 76:948–959. https://doi.org/10.1136/annrheumdis-2016-210602

    Article  PubMed  Google Scholar 

  52. Peterfy CG, Wu C, Szechinski J et al (2011) Comparison of the Genant-modified Sharp and van der Heijde-modified Sharp scoring methods for radiographic assessment in rheumatoid arthritis. Int J Clin Rheumtol 6:15–24. https://doi.org/10.2217/ijr.11.1

    Article  Google Scholar 

  53. Rau R, Wassenberg S, Herborn G et al (1998) A new method of scoring radiographic change in rheumatoid arthritis. J Rheumatol 25:2094–2107

    CAS  PubMed  Google Scholar 

  54. Van Der Heijde D, Dankert T, Nieman F et al (1999) Reliability and sensitivity to change of a simplification of the Sharp/van der Heijde radiological assessment in rheumatoid arthritis. Rheumatology 38:941–947. https://doi.org/10.1093/rheumatology/38.10.941

    Article  PubMed  Google Scholar 

  55. Dias EM, Lukas C, Landew R et al (2008) Reliability and sensitivity to change of the Simple Erosion Narrowing Score compared with the Sharp-van der Heijde method for scoring radiographs in rheumatoid arthritis. Ann Rheum Dis 67:375–379. https://doi.org/10.1136/ard.2007.072785

    Article  CAS  PubMed  Google Scholar 

  56. Barnabe C, Hazlewood G, Barr S, Martin L (2012) Comparison of radiographic scoring methods in a cohort of RA patients treated with anti-TNF therapy. Rheumatology 51:878–881. https://doi.org/10.1093/rheumatology/ker418

    Article  PubMed  Google Scholar 

  57. Oude Voshaar MAH, Schenk O, ten Klooster PM et al (2016) Further simplification of the simple erosion narrowing score with item response theory methodology. Arthritis Care Res 68:1206–1210. https://doi.org/10.1002/acr.22793

    Article  CAS  Google Scholar 

  58. Wassenberg S, Herborn G, Larsen A et al (1998) Reliability, precision and time expense of four different radiographic scoring methods [abstract]. Arthritis Rheum 41:S104

    Google Scholar 

  59. Van Der Heijde D, Boonen A, Boers M et al (1999) Reading radiographs in chronological order, in pairs or as single films has important implications for the discriminative power of rheumatoid arthritis clinical trials. Rheumatology 38:1213–1220. https://doi.org/10.1093/rheumatology/38.12.1213

    Article  Google Scholar 

  60. Mease PJ, Ory P, Sharp JT et al (2009) Adalimumab for long-term treatment of psoriatic arthritis: 2-Year data from the adalimumab effectiveness in psoriatic arthritis trial (ADEPT). Ann Rheum Dis 68:702–709. https://doi.org/10.1136/ard.2008.092767

    Article  CAS  PubMed  Google Scholar 

  61. Gladman D, Mease P, Ritchlin C et al (2007) Adalimumab for long-term treatment of psoriatic arthritis: forty-eight week data from the adalimumab effectiveness in psoriatic arthritis trial. Arthritis Rheum 56:476–488

    Article  CAS  PubMed  Google Scholar 

  62. Gladman DD, Mease PJ, Strand V et al (2007) Consensus on a core set of domains for psoriatic arthritis. J Rheumatol 34:1167–1170

    PubMed  Google Scholar 

  63. Rahman P, Gladman DD, Cook RJ et al (1998) Radiological assessment in psoriatic arthritis. Br J Rheumatol 37:760–765

    Article  CAS  PubMed  Google Scholar 

  64. Wassenberg S, Fischer-Kahle V, Herborn G, Rau R (2001) A method to score radiographic change in psoriatic arthritis. Z Rheumatol 60:156–166. https://doi.org/10.1007/s003930170064

    Article  CAS  PubMed  Google Scholar 

  65. Rahman P, Nguyen E, Cheung C et al (2001) Comparison of radiological severity in psoriatic arthritis and rheumatoid arthritis. J Rheumatol 28:1041–1044

    CAS  PubMed  Google Scholar 

  66. Gladman DD, Mease PJ, Choy EHS et al (2010) Risk factors for radiographic progression in psoriatic arthritis: subanalysis of the randomized controlled trial ADEPT. Arthritis Res Ther 12:R113. https://doi.org/10.1186/ar3049

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Salaffi F, Carotti M, Di Donato E et al (2018) Preliminary validation of the simplified psoriatic arthritis radiographic score (SPARS). Skeletal Radiol. https://doi.org/10.1007/s00256-018-3124-0

    Article  PubMed  Google Scholar 

  68. Tillett W, Jadon D, Shaddick G et al (2014) Feasibility, reliability, and sensitivity to change of four radiographic scoring methods in patients with psoriatic arthritis. Arthritis Care Res 66:311–317. https://doi.org/10.1002/acr.22104

    Article  CAS  Google Scholar 

  69. Aletaha D, Neogi T, Silman AJ et al (2010) 2010 Rheumatoid arthritis classification criteria : an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 62:2569–2581

    Article  PubMed  Google Scholar 

  70. Zlatkovic-Svenda MI, Kerimovic-Morina D, Stojanovic RM (2011) Psoratic arthritis criteria evaluation: cASPAR and modified CASPAR. Clin Exp Rheumatol 29:899–900

    PubMed  Google Scholar 

  71. Kainberger F, Peloschek P, Langs G et al (2004) Differential diagnosis of rheumatic diseases using conventional radiography. Best Pract Res Clin Rheumatol 18:783–811. https://doi.org/10.1016/j.berh.2004.07.004

    Article  PubMed  Google Scholar 

  72. Van Tuyl LHD, Felson DT, Wells G et al (2010) Evidence for predictive validity of remission on long-term outcome in rheumatoid arthritis: a systematic review. Arthritis Care Res 62:108–117. https://doi.org/10.1002/acr.20021

    Article  Google Scholar 

  73. Welsing PMJ, Van Gestel AM, Swinkels HL et al (2001) The Relationship between disease activity, joint destruction, and functional capacity over the course of rheumatoid arthritis. Arthritis Rheum 44:2009–2017. https://doi.org/10.1002/1529-0131(200109)44:9%3c2009:AID-ART349%3e3.0.CO;2-L

    Article  CAS  PubMed  Google Scholar 

  74. Aletaha D, Funovits J, Smolen JS (2011) Physical disability in rheumatoid arthritis is associated with cartilage damage rather than bone destruction. Ann Rheum Dis 70:733–739. https://doi.org/10.1136/ard.2010.138693

    Article  PubMed  Google Scholar 

  75. Anandarajah A (2013) Imaging in psoriatic arthritis. Clin Rev Allergy Immunol 44:157–165. https://doi.org/10.1007/s12016-012-8304-4

    Article  PubMed  Google Scholar 

  76. Østergaard M, Pedersen SJ, Døhn UM (2008) Imaging in rheumatoid arthritis—status and recent advances for magnetic resonance imaging, ultrasonography, computed tomography and conventional radiography. Best Pract Res Clin Rheumatol 22:1019–1044. https://doi.org/10.1016/j.berh.2008.09.014

    Article  PubMed  Google Scholar 

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  1. Rheumatological Clinic, Ospedale “Carlo Urbani”, Università Politecnica delle Marche, Via Aldo Moro, 25, 60035, Jesi, Ancona, Italy

    Fausto Salaffi, Giacomo Beci & Marco Di Carlo

  2. Radiology Department, Università Politecnica delle Marche, Ancona, Italy

    Marina Carotti & Andrea Giovagnoni

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  1. Fausto Salaffi
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  2. Marina Carotti
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Salaffi, F., Carotti, M., Beci, G. et al. Radiographic scoring methods in rheumatoid arthritis and psoriatic arthritis. Radiol med 124, 1071–1086 (2019). https://doi.org/10.1007/s11547-019-01001-3

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