Figure 1.

Ultrasonic scoring criteria for joint involvement. A-D. Bone changes scored with ultrasonography, with each joint visualized in 2 planes (longitudinal and transverse). A. Grade 0: regular bone surface; B. Grade 1: irregularity of the bone surface without formation of a defect seen in 2 planes (arrow); C. Grade 2: formation of a defect in the surface of the bone seen in 2 planes (arrow); D. Grade 3: bone defect creating extensive bone destruction (arrow). E-H. Joint effusion on ultrasonography. E. Grade 0: no fluid; F. Grade 1: minimal amount of fluid (arrow); G. Grade 2: moderate amount of fluid (without distension of the joint capsule) (arrow); H. Grade 3: extensive amount of fluid (with distension of the joint capsule) (arrow). I-L. Synovial changes on ultrasonography. I. Grade 0: no synovial thickening; J. Grade 1: minimal synovial thickening (filling the angle between the periarticular bones, without bulging over the line linking tops of the bones); K. Grade 2: synovial thickening bulging over the line linking tops of the periarticular bones but without extension along the bone diaphysis; L. Grade 3: synovial thickening bulging over the line linking tops of the periarticular bones and with extension to at least one of the bone diaphyses. M-P. Power Doppler signal. M. Grade 0: no flow in the synovium; N. Grade 1: up to three single Doppler spots or up to one confluent spot and two single spots or up to two confluent spots; O. Grade 2: greater than Grade 1 but <50% Doppler signals in the total GS background; P. Grade 3: greater than Grade 2 (>50% of the background GS).