title: Proposal for a sonographic classification of target joints in rheumatoid arthritis.
abstract: OBJECTIVE
  The purpose of this study was to classify sonographically the joint damage of target joints in patients with rheumatoid arthritis (RA).
  
  
  METHODS
  During a 3-year cross-sectional study, standardized arthrosonography of symptomatic target joints was performed in patients with RA. According to those findings, a classification with progressive deterioration of joint alteration in RA was created that grades visible morphological changes of the joint components. Using elbow joints as a subgroup, inter- and intraobserver reliability was calculated.
  
  
  RESULTS
  Examined and included in this study were 1211 joints of 425 patients with RA. The mean disease activity score was 5.2 (range 0.75-7.79). Sonographically visible changes could be classified and divided into six stages. A standardized sonographic evaluation system was developed. In reference to the elbow joint, overall percentages for intra- and interobserver reliability of sonography were 90.8% and 88.8%, respectively.
  
  
  CONCLUSIONS
  Sonography is a valuable tool for assessing and classifying joint alteration in RA. Particularly in early stages of joint affection, ultrasound is superior to X-ray in detecting soft tissue changes and minor erosions.
authors.affiliation: Department of Orthopedic Surgery, University of Regensburg, Kaiser-Karl-V. Allee 3, Bad Abbach, Germany. klaus.lerch@klinik.uni-regensburg.de
authors.forename: Klaus
authors.initials: K
authors.lastname: Lerch
authors.forename: Nicola
authors.initials: N
authors.lastname: Borisch
authors.forename: Christian
authors.initials: C
authors.lastname: Paetzel
authors.forename: Joachim
authors.initials: J
authors.lastname: Grifka
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hartung
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000145:classification* / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D018450:Disease Progression; D042241:Early Diagnosis; D004551:Elbow Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors; D018608:Ultrasonography, Doppler / Q000379:methods*