Preliminary validation of the Simplified Psoriatic Arthritis Radiographic Score (SPARS)
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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.
KeywordsPsoriatic arthritis Radiography Diagnostic imaging
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
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.
- 8.Gottlieb A, Korman NJ, Gordon KB, Feldman SR, Lebwohl M, Koo JY, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 2. Psoriatic arthritis: overview and guidelines of care for treatment with an emphasis on the biologics. J Am Acad Dermatol. 2008;58(5):851–64.CrossRefPubMedGoogle Scholar
- 19.Kavanaugh A, McInnes IB, Mease PJ, Krueger GG, Gladman DD, van der Heijde D, et al. Clinical efficacy, radiographic and safety findings through 2 years of golimumab treatment in patients with active psoriatic arthritis: results from a long-term extension of the randomised, placebo-controlled GO-REVEAL study. Ann Rheum Dis. 2013;72(11):1777–85.CrossRefPubMedPubMedCentralGoogle Scholar
- 22.Bruynesteyn K, van der Heijde D, Boers M, Lassere M, Boonen A, Edmonds J, et al. Minimal clinically important difference in radiological progression of joint damage over 1 year in rheumatoid arthritis: preliminary results of a validation study with clinical experts. J Rheumatol. 2001;28(4):904–10.PubMedGoogle Scholar
- 27.Lee JC, Gladman DD, Schentag CT, Cook RJ. The long-term use of azathioprine in patients with psoriatic arthritis. J Clin Rheumatol. 2001;7(3):160–5.Google Scholar
- 29.Ostergaard M, McQueen F, Wiell C, Bird P, Bøyesen P, Ejbjerg B, et al. The OMERACT psoriatic arthritis magnetic resonance imaging scoring system (PsAMRIS): definitions of key pathologies, suggested MRI sequences, and preliminary scoring system for PsA hands. J Rheumatol. 2009;36(8):1816–24.CrossRefPubMedGoogle Scholar
- 32.van der Heijde D, Kavanaugh A, Gladman DD, Antoni C, Krueger GG, Guzzo C, et al. Infliximab inhibits progression of radiographic damage in patients with active psoriatic arthritis through one year of treatment: results from the induction and maintenance psoriatic arthritis clinical trial 2. Arthritis Rheum. 2007;56(8):2698–707.CrossRefPubMedGoogle Scholar
- 33.Mease PJ, Gladman DD, Ritchlin CT, Ruderman EM, Steinfeld SD, Choy EH, et al. Adalimumab for the treatment of patients with moderately to severely active psoriatic arthritis: results of a double-blind, randomized, placebo-controlled trial. Arthritis Rheum. 2005;52(10):3279–89.CrossRefPubMedGoogle Scholar
- 35.Geijer M, Lindqvist U, Husmark T, Alenius GM, Larsson PT, Teleman A, et al. The Swedish early psoriatic arthritis registry 5-year follow-up: substantial radiographic progression mainly in men with high disease activity and development of dactylitis. J Rheumatol. 2015;42(11):2110–7.CrossRefPubMedGoogle Scholar
- 41.Ejbjerg BJ, Vestergaard A, Jacobsen S, Thomsen HS, Østergaard M. The smallest detectable difference and sensitivity to change of magnetic resonance imaging and radiographic scoring of structural joint damage in rheumatoid arthritis finger, wrist, and toe joints: a comparison of the OMERACT rheumatoid arthritis magnetic resonance imaging score applied to different joint combinations and the Sharp/van der Heijde radiographic score. Arthritis Rheum. 2005;52(8):2300–6.CrossRefPubMedGoogle Scholar