A Semiquantitative Ultrasound Scoring System for Assessment of Cartilage Damage in RA

person getting ultrasound of hand
person getting ultrasound of hand
The validity of the Outcome Measure in Rheumtology (OMERACT) score is compared with a sonographic assessment of cartilage in patients with rheumatoid arthritis.

The Outcome Measure in Rheumatology (OMERACT) semiquantitative ultrasound scoring system should be considered for assessment of cartilage damage in patients with rheumatoid arthritis (RA), according to study data published in Rheumatology.

Although conventional radiography only detects indirect signs of cartilage pathology, ultrasound may provide a more comprehensive assessment of joint damage. Recently, the OMERACT US (ultrasound) Working Group developed a semiquantitative ultrasound scoring system to assess the hyaline cartilage of the metacarpal head (MH) in RA. In this study, researchers sought to test the validity of this system by comparing it with a quantitative method in patients with RA and healthy control participants.

They scanned the hyaline cartilage from the second to fifth MHs of both hands and scored it semiquantitatively and quantitatively by measuring cartilage thickness and comparing it with reference values. In patients with RA, radiographic joint space narrowing (JSN) was scored on the same joints using the Simple Erosion Narrowing Score (SENS). A total of 408 MHs in 51 patients with RA and 320 MHs in 40 HSs were evaluated. The researchers found that the OMERACT semi-quantitative score was quicker to perform than the quantitative method (6.0 vs 8.0 minutes; P<.01), and a significant correlation between the ultrasound scores and between the ultrasound scores and the JSN-SENS was identified. The frequency of cartilage abnormalities was similar between the 2 ultrasound methods in patients with RA (58.8% and 51.0% of patients with RA for the semi-quantitative and quantitative method, respectively; P=.46), while the former revealed more abnormalities in the healthy control group. (27.5% and 7.5% of healthy control participants; P=.02).

Limitations of the study were cited as the small sample size and the monocentric design, both of which limit the ability to generalize the results.

The study authors concluded, “The higher feasibility of the OMERACT semiquantitative score suggests its use as first-choice method in the evaluation of cartilage damage.”  

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 


Cipolletta E, Mandl P, Di Matteo A, et al. Sonographic assessment of cartilage damage at metacarpal head in rheumatoid arthritis: qualitative versus quantitative methods. Rheumatology. Published online June 7, 2021. doi:10.1093/rheumatology/keab472