A comparison between the simplified erosion and narrowing score and the Sharp–van der Heijde score: post hoc analysis from the BeSt study

The Sharp–van der Heijde method (SHS; range 0–448)1 is an often used and well-validated method to assess joint damage on x-rays in rheumatoid arthritis (RA). It is a comprehensive method that requires training, making it less feasible for clinical practice. The simplified erosion and narrowing score (SENS; range 0–86)2 scores the same joints as SHS, but without grading of damage per joint, making it quicker and easier to learn. Using SENS takes 7 min for seven sets of radiographs, compared with 25 min for seven sets using SHS.2 In earlier studies, SENS showed good reliability and responsiveness, but these studies either had no restrictions in disease duration or limited patient numbers.2–4 We aimed to compare the properties of SENS and SHS in a large group of early, intensively treated RA patients with limited joint damage during 5 years of follow-up in the BeSt (Behandel Strategieen [Treatment Strategies]) study. Details of the study have been described earlier.5 Annual radiographs of hands and feet …