Our objective was to compare the reliability and responsiveness of the
original Steinbrocker's (OS), our modified Steinbrocker's (MS) and La
rsen's (L) radiological scoring methods for detecting radiological cha
nge in psoriatic arthritis over time. Two sets of radiographs of the h
ands and feet at least 2 yr apart were selected from 68 patients. Film
s were randomly presented and scored independently by a rheumatologist
(DDG) and a radiologist (DS), in a blinded fashion using all methods.
The index of reliability was the intraclass coefficient (ICC) and the
responsiveness was assessed using plots and regression analyses. All
three radiological scoring methods have excellent interobserver and go
od intra-observer reliability. L and MS are equally responsive and sup
erior to OS in detecting change in joint damage over time. Thus, the L
or MS radiological scoring methods can be used to monitor disease pro
gression in psoriatic arthritis.