Radiological assessment of rheumatoid arthritis.

a study was made of interand intra-observer differences in grading hand films for rheumatoid arthritis during the course of therapeutic trials and field surveys. This study indicated that standards used so far in grading x-ray changes for rheumatoid arthritis in field surveys in Leigh and South Wales did not differ greatly from the mean values given by physicians and radiologists in Britain. Before attempting to produce standard films for use in future surveys, it was decided to seek the help of a number of workers in different parts of the world, so that any national bias in assessing such changes could be avoided. Advantage was, therefore, taken of the presence in Toronto of experienced rheumatologists from many countries on the occasion of the XI International Congress of Rheumatic Diseases in June, 1957. During this Congress a series of nineteen hand x-rays with varying degrees of rheumatoid arthritis and osteo-arthrosis were exhibited in the form of a radiological quiz, and members of the Congress were asked to grade these for osteo-porosis and rheumatoid erosions and to give an overall grading for rheumatoid arthritis and osteo-arthrosis (degenerative joint disease). Each of these features was to be graded into five categories: 0 = None