Scoring item |
Grades | ||||||
Epiphysis | |||||||
Bone marrow oedema | |||||||
Extent* |
No oedema |
<50% of epiphyseal volume |
>50% of epiphyseal volume | ||||
Location10 32 |
No oedema |
Oedema adjacent to physis |
Oedema not adjacent to physis | ||||
Signal intensity* |
No oedema |
1 |
2 |
3 |
4 |
5 | |
Visibility on 3D WATSc* |
No oedema |
Oedema not visible |
Oedema visible | ||||
Physis | |||||||
Thickness9 20 |
Normal |
Increased | |||||
Location of thickness20 |
No increased thickness |
Increased on radial side |
Increased on ulnar side | ||||
Thickness compared with proximal physis of MC-1* |
Not increased |
Twice |
Three times |
Four times | |||
Signal intensity8 |
1 |
2 |
3 |
4 |
5 | ||
Disruptions32 33 |
No disruptions |
1 |
2 |
>2 disruptions | |||
Width of disruptions* |
No disruptions |
<2 mm |
≥2 mm | ||||
Physeal border on epiphyseal side25 |
Undulating |
Irregular | |||||
Depth of irregularities* |
No irregularities |
<Thickness of physis |
>Thickness of physis | ||||
Metaphysis | |||||||
Physeal border on metaphyseal side25 |
Undulating |
Slightly irregular |
Distinctly irregular | ||||
Metaphyseal intrusions32 34 |
Absent |
Present | |||||
Signal intensity intrusions* |
No intrusions |
Less than physis |
Same as physis |
Higher than physis | |||
Connection of intrusion with physis* |
No intrusions |
Connected with physis |
Not connected with physis | ||||
Depth of intrusions* |
No intrusions |
<2 mm |
>2 mm | ||||
Bone marrow oedema | |||||||
Presence10 32 |
Present |
Absent | |||||
Depth* |
No oedema |
Area <2 cm from physis |
Area ≥2 cm from physis | ||||
Location10 32 |
No oedema |
Oedema adjacent to physis |
Oedema not adjacent to physis | ||||
Signal intensity* |
No oedema |
1 |
2 |
3 |
4 |
5 | |
Visibility on 3D WATSc* |
No oedema |
Oedema not visible |
Oedema visible | ||||
Homogeneity* |
No oedema |
Homogeneous oedema |
Inhomogeneous oedema | ||||
Shape25 |
Normal |
Unilateral widening |
Bilateral widening | ||||
Location of widening* |
No widening |
Radial |
Ulnar | ||||
Periosteal bone formation10 |
Absent |
Present | |||||
Sclerosis2 9 |
Absent |
Present |
*Item added based on clinical experience with evaluation of physeal stress injuries.
3D WATSc, three-dimensional water-selective cartilage scan; MC-1, first metacarpal bone.