submit a patient

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Personal information

Name: *

Email: *

Institution: *

Radiographies

Serial code:

Date taken:

Record date

Check if you want scoresharp to record the entered date

Left foot: *

Right foot: *

Left hand: *

Right hand: *

Patient information

Age:

Age of the patient when the radiographies were taken

Sex:

Title:

Comments:

Time elapsed since symptoms first appeared (years):

Number of years elapsed between the first apparition of arthritis symptoms and the moment when the radiographies were taken.

Time elapsed since symptoms first appeared (months):

Number of months elapsed between the first apparition of arthritis symptoms and the moment when the radiographies were taken.

Time elapsed since symptoms first appeared (weeks):

Number of days elapsed between the first apparition of arthritis symptoms and the moment when the radiographies were taken.

Rhumatoid factor:

Rhumatoid factor value:

If rhumatoid factor is positive, indicate value superior to normal. Can be expressed in international units/ml or in dilution.

Anti-CCP:

Anti-cyclic citrullinated peptides

Anti-CCP value:

If anti-CCP is positive, indicate value superior to normal.

Anti-CCP normal values:

Values considered normal in your laboratory.

DAS:

DAS-28:

DMARD medication in use:

Extra-articular manifestations:

e.g. psoriasis, rheumatoid nodules

Rheumatology