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Table 2 Assessment score sheet for ERL in children with JDM and their controls

From: Nailfold capillary density in 140 untreated children with juvenile dermatomyositis: an indicator of disease activity

ID #: _____________

Name: ____________________

Date of Exam: ____/____/____

 

Right Hand

Left Hand

2nd

3rd

4th

5th

2nd

3rd

4th

5th

Total number of loops /3mm

        

Calculated number loops /mm

(x total number of loops/3)

        

Number dilated /3 mm:

        

Severity of dilation:

1 = mild, 2 = moderate, 3 = severe

        

Avascular Pattern:

1 = periungual, 2 = patchy, 3 = both

        

Severity of avascularity:

1 = mild, 2 = moderate, 3 = severe

        

Predominant pattern:

        

1 = open

2 = crossed

3 = tortuous

4 = undefined

5 = bushy

6 = bushy

Number bushy loops /3mm:

        

Number Branched Points /3mm:

        

Number of Hemorrhages (any):

        

GLOBAL

 Avg. end row loops /mm:

 

 Impression:

1 = Normal 2 = Abnormal

 

Date entered ___/___/___ by (initials)____

Date verified ___/___/___ by (initials)____