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Exception to the rule is a unilateral score of 3 with an intact muscle on the other side (Fig. 10c).
In case of a complete detachment from the insertion on the pubis, the maximum score is appointed, i.e. a unilateral score of 3 (Table 1).
Table 2 Classification system of pubovisceral muscle avulsions Category Total score No defect 0 Minor avulsion 1 3 Major avulsion 4 6 or unilateral score of 3 Open image in new window Fig. 10 T2-weighted MR images of the different types of pubovisceral muscle avulsions (axial plane).
In situations, where a high sensitivity is less relevant (for example, use of sonography to monitor treatment response) the unilateral score may be preferred, whereas for remission assessment the bilateral ultrasound score may produce more valuable results.
ICCs of the GUIS components ranged from 0.42 (GS-teno) to 0.96 (PD-j) for the bilateral composite score and from 0.36 (GS-teno) to 0.71 (PD-j) for the unilateral score.
The unilateral score (PsASon13) compromised 13 joints (2 MCPs, 3 H-PIPs, 1 PIP of feet (F-PIP), 2 MTPs, 1 H-DIP and 2 F-DIPs and 2 large joints) and 2 entheses (unilateral lateral epicondyle and distal patellar tendon).
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A final score is obtained by adding up the unilateral scores (total score: range 0 6).
In case of some degree of connection of the pubovisceral muscle to the pubis, the amount of muscle bulk missing is quantified (Table 1). Figure 9a d show a schematic representation of the unilateral scores 0 3.
Median unilateral scores are expressed in Table 1.
The median time to complete the bilateral and unilateral scores was 19 minutes (range 16 to 26) and 10 (9 to 13) minutes, respectively.
We constructed a bilateral and a unilateral composite score (focusing on the dominant site) using the Spanish 12-joint and the German 7-joint scores, respectively, as examples [ 6, 19].
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com