How-to-Score Synovitis Using The HEAD-US System

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1 How-to-Scoe Synovitis Using The HEAD-US System REFEU385 Date of eaation: Noveme 2014 This educational ogamme is suoted y Pfize

GRADE-0 (asent/minimal) GRADE-1 (mild/modeate) a the adial (a) and coonoid ecesses ae emty o minimally distended with a concave shae minimal synovium at the joint line may oduce a concave ofile not

assume a convex shae (c) ut synovium doesn't show continuity with the joint line (d) and the annula ecess Elow - osteio (E3) synovium extends into the olecanon fossa eaching its floo (e).

2 GRADE-0 (asent/minimal) GRADE-1 (mild/modeate) a the adial (a) and coonoid ecesses ae emty o minimally distended with a concave shae minimal synovium at the joint line may oduce a concave ofile not otuding ove the adjacent one sufaces Elow - osteio (E3) the floo of the olecanon fossa () is emty minimal ulge of synovium may e found at the joint line d c e the distended adial and coonoid ecesses assume a convex shae (c) ut synovium doesn't show continuity with the joint line (d) and the annula ecess Elow - osteio (E3) synovium extends into the olecanon fossa eaching its floo (e). It aeas in continuity with the joint line and occuies <50% of the exected full volume of the ecess g f e full distension of adial and coonoid ecesses. Synovium foms a continuum (f) ove the anteio joint the annula ecess (g) is distended Elow - osteio (E3) synovium occuies >50% of the exected full volume of the ecess

GRADE-0 (asent/minimal) i h GRADE-1 (mild/modeate) j k n l i n Knee - suaatella (K1) the suaatella (h) ecess is emty o minimally distended small synovial amount is detected etween

the aaatella ecesses (i) ae emty minimal ulge of synovium may e found at the atellofemoal joint line not extending ove the flat suface of the femoal condyles Knee - suaatella (K1)

synovium fills at of the aaatella ecess (k) o extend thoughout the ecess (l) filling <50% of its exected full volume Knee - suaatella (K1) maked distension (m) of the suaatella

3 GRADE-0 (asent/minimal) i h GRADE-1 (mild/modeate) j k n l i n Knee - suaatella (K1) the suaatella (h) ecess is emty o minimally distended small synovial amount is detected etween the suaatella and the efemoal fat ads, ut synovium doesn't extend oximally etween the quadices and the efemoal fat ad (dashed line indicates the limit) Knee - aaatella (K2A, K2B) the aaatella ecesses (i) ae emty minimal ulge of synovium may e found at the atellofemoal joint line not extending ove the flat suface of the femoal condyles Knee - suaatella (K1) synovium extends oximally etween the undesuface of the quadices tendon and the efemoal fat ad the full amount of ecess distension is shown in one scan Knee - aaatella (K2A, K2B) synovium fills at of the aaatella ecess (k) o extend thoughout the ecess (l) filling <50% of its exected full volume Knee - suaatella (K1) maked distension (m) of the suaatella ecess with synovium extending too much canially to e comehensively demonstated in one scan Knee - aaatella (K2A, K2B) synovium occuies >50% of the exected full volume (n) of the ecess m

GRADE-0 (asent/minimal) o q GRADE-1 (mild/modeate) o s Ankle - tiiotala joint (A1A, A3/A3A) the anteio (a) and osteio () ecesses ae emty o minimally distended with a concave shae small synovium

4 GRADE-0 (asent/minimal) o q GRADE-1 (mild/modeate) o s Ankle - tiiotala joint (A1A, A3/A3A) the anteio (a) and osteio () ecesses ae emty o minimally distended with a concave shae small synovium amounts may e found distally (q) in the anteio ecess, at the level of the tala neck. In this latte location, synovium doesn't show continuity with the joint line the anteio and osteio () ecesses ae emty Ankle - tiiotala joint (A1A, A3/A3A) synovium foms a continuum (s) ove the anteio ecess of the tiiotala joint, occuying <50% of the exected full volume of the ecess some ulge of synovium is found in the osteio ecess () some ulge of synovium lying is found in the osteio ecess (). The distended anteio ecess fills <50% of the sinus tasi u Ankle - tiiotala joint (A1A, A3/A3A) synovium foms a continuum (u) in the anteio ecess of the tiiotala joint, occuying >50% of the exected full volume of the ecess eccentic ulge of synovium occuies >50% of the exected full volume of the osteio ecess () eccentic ulge of synovium occuies >50% of the exected full volume of the osteio ecess () The distended anteio ecess fills >50% of the sinus tasi

5 Note. In the elow and knee, the final scoe fo synovitis deives fom the aveage of the scoes that have esulted fom the individual ecesses. When evaluating synovitis at the ankle level, the final scoe is the highest scoe calculated at eithe the tiiotala o the sutala level as these two joints ae indeendent stuctues. Examines using the HEAD-US system ae exected to follow these guidelines to scoe synovitis in the elows, knees and ankles of atients with haemohilic athoathy. Although aitay, these ules aim at imoving education and actice as well as educing valiaility in the inteetation of findings among diffeent institutions and eole with diffeent ofessional skills and levels of cometence. The validity of these ules is stictly elated to the HEAD-US achitectue 1. In othe wods, they don't eesent a standad fo inteetation of synovitis outside the HEAD-US context. 1. MARTINOLI C., DELLA CASA ALBERIGHI O., Di MINNO G., GRAZIANO E., MOLINARI A.C., PASTA G., RUSSO G., SANTAGOSTINO E., TAGLIAFERRI A., TAGLIAFICO A., MORFINI M. Develoment and definition of a simlified scanning ocedue and scoing method fo Haemohilia Ealy Athoathy Detection with Ultasound (HEAD-US). Thom Haemost 109(6): , 2013 This ogamme is suoted y Pfize with the aim to imove education and actice in the context of haemohilia deatments as well as to estalish the use of ultasound as a diagnostic modality to assess the status of joints in haemohilia atients. The HEAD-US scheme does not enale examines to efom a comehensive diagnostic ultasound evaluation of the musculoskeletal system in these atients and cannot e alied in a clinical setting othe than haemohilia

OR G A N I S A T I O N A L LY R E L E VA N T VA R I A B L E S A N D KE Y E S'S ME N TA L HE A LT H

Oiginal Reseach OR G A N I S A T I O N A L LY R E L E VA N T VA R I A B L E S A N D KE Y E S'S ME N TA L HE A LT H CONTINUUM SCALE: AN EXPLORATORY STUDY Authos: Deo J.W. Stümfe 1 Anneli Hady 2 Joan S.