Tenosynovitis is a very common disease manifestation in patients with rheumatoid arthritis (RA). It has been associated with lower physical function and may be one of the best imaging predictors for early development of RA. Several studies have confirmed the limitations of clinical examination for detection of tenosynovitis in comparison with ultrasound (US). Using US for tenosynovitis detection requires a highly validated and reliable US scoring system. The Outcome Measures in Rheumatology Clinical Trials group proposed a tenosynovitis scoring system described by Ammitzbøl-Danielsen et al. (2017). Focusing on the US part of this scoring system they grade the US findings in tenosynovitis as:
Greyscale US > grade:
0: normal
1: minimal
2: moderate
3: severe
Doppler US > grade:
0: no intratenosynovial Doppler signal
1: focal intratenosynovial Doppler activity
2: multifocal intratenosynovial Doppler activity
3: diffuse intratenosynovial Doppler activity
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