Preliminary validation of the Simplified Psoriatic Arthritis Radiographic Score (SPARS)

  • Fausto Salaffi
  • Marina Carotti
  • Eleonora Di Donato
  • Marco Di CarloEmail author
  • Michele Maria Luchetti
  • Luca Ceccarelli
  • Andrea Giovagnoni
Scientific Article



To develop and validate in a preliminary way a novel radiographic scoring system for psoriatic arthritis (PsA), called Simplified Psoriatic Arthritis Radiographic Score (SPARS).

Materials and methods

Radiographs of hands and feet were obtained from consecutive PsA patients and assessed by two readers. For each joint (30 joints in the hands, ten joints in the feet), the combination of the erosions, joint narrowing space (JNS) and bony proliferation (BP) has been assessed, giving a value of 1 for erosions presence, 1 for JNS presence, and 1 for BP presence (SPARS score range, 0–120). Reliability was assessed by calculating the intraclass correlation coefficient (ICC) and smallest detectable difference (SDD) of the readings. To determine the convergent validity, SPARS was compared to the modified Sharp/van der Heijde Score (mSvdHS) and to the Ratingen scoring system (PARS).


One-hundred and five hands and feet radiographs have been assessed. The inter- and intra-rater reliability were excellent (inter-rater reliability 0.934, and intra-rater reliability for both readers 0.845 and 0.876). The SDD for the average SPARS scores of the two readers was 8.0. SPARS correlated strongly with mSvdHS (r = 0.926; p < 0.0001), and PARS (r = 0.904; p < 0.0001). The mean time to score each of the mSvdHS, PARS, and SPARS was 14.4, 10.1, and 4.5 min, respectively.


The SPARS properties are close to those of the mSvdHS and PARS and is quicker to calculate.


Psoriatic arthritis Radiography Diagnostic imaging 


Authors’ contributions

FS, MC, and AG contributed to the study design. FS, MC, EDD, MDC, MML, and LC performed the data collection. FS, MC, and MDC were involved in data analysis and in the interpretation of the results. FS, EDD, and MDC drafted the manuscript. All authors were involved in revising the article, and all authors approved the final version submitted for publication.

Compliance with ethical standards

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of our institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© ISS 2018

Authors and Affiliations

  1. 1.Rheumatological ClinicUniversità Politecnica delle Marche, “Carlo Urbani” HospitalJesiItaly
  2. 2.Radiology DepartmentUniversità Politecnica delle MarcheAnconaItaly
  3. 3.Medical ClinicUniversità Politecnica delle MarcheAnconaItaly

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