Compatible scales for progressive and additive MRI assessments of haemophilic arthropathy

Abstract

The international MRI expert subgroup of the International Prophylaxis Study Group (IPSG) has developed a consensus for magnetic resonance imaging (MRI) scales for assessment of haemophilic arthropathy. A MRI scoring scheme including a 10 step progressive scale and a 20 step additive scale with identical definitions of mutual steps is presented. Using the progressive scale, effusion/haemarthrosis can correspond to progressive scores of 1, 2, or 3, and synovial hypertrophy and/or haemosiderin deposition to 4, 5, or 6. The progressive score can be 7 or 8 if there are subchondral cysts and/or surface erosions, and it is 9 or 10 if there is loss of cartilage. Using the additive scale, synovial hypertrophy contributes 1-3 points to the additive score and haemosiderin deposition contributes 1 point. For osteochondral changes, 16 statements are evaluated as to whether they are true or false, and each true statement contributes 1 point to the additive score. The use of these two compatible scales for progressive and additive MRI assessments can facilitate international comparison of data and enhance the accumulation of experience on MRI scoring of haemophilic arthropathy.

State‐of‐the‐art imaging techniques for the evaluation of haemophilic arthropathy: present and future

“…In 2005, the International Prophylaxis Study Group (IPSG) presented a preliminary comprehensive scoring scheme [22,26,27] that combined the pioneer Denver [20] and European MRI scores [21]. The use of such scales should result in a more consistent assessment of haemophilic joints and should facilitate the development of more targeted treatment to prevent or delay further destructive osteoarticular changes.…”

“…To measure arthropathic changes in clinical practice and in clinical research trials, tentative haemophilic arthropathy scales based on MRI findings have been developed in the last decade [20][21][22][23][24][25]. In 2005, the International Prophylaxis Study Group (IPSG) presented a preliminary comprehensive scoring scheme [22,26,27] that combined the pioneer Denver [20] and European MRI scores [21].…”

Modern management of haemophilic arthropathy

“…Recently, magnetic resonance imaging (MRI) has been used as a more sensitive imaging technique that can detect changes that are not visualised by conventional radiographs, and several scoring methods using MRI have been proposed Soler et al, 2002;Lundin et al, 2004). An international MRI expert subgroup of the International Prophylaxis Study Group (IPSG), under the auspices of the WFH has recently reviewed and revised these scales to develop the compatible MRI scoring system (Lundin et al, 2005). This scoring system has two components to assess both progressive and additive MRI changes.…”

Hemophilic arthropathy of the elbow: prophylaxis, imaging, and the role of invasive management

“…10 The original IPSG scale had 2 components: a 10-step progressive scale and a 20-step additive scale (Table II). 22,23 Subsequent experience revealed that the 10-step progressive scale reached a maximal score too soon, and although the 20-step additive scale more accurately described the level of arthropathy, it was not designed to ''stand alone.'' The revised scale, termed the IPSG MRI scale, is additive with a single scoring system, and it includes soft tissue changes, such as effusion and hemarthrosis, which were excluded from the previous IPSG scale (Table III).…”