The New ‘Coimbra Method’: A Biologically Appropriate Method for Recording Specific Features of Fibrocartilaginous Entheseal Changes

This paper presents a revised version of the Coimbra method for recording fibrocartilaginous entheses. The method itself is the only biologically appropriate recording method for fibrocartilaginous entheses that scores features separately, thereby ensuring that the aetiology of individual features can be studied. The method divides the enthesis into two zones, scoring the relevant features in each zone. These features represent either bone formation or bone destruction and include erosive lesions, fine and macro‐porosity, and cavitations. The revised method includes a new feature, textural change, which is scored as absent or present when it involves 50% or more of the surface. All other features are now scored as zero (absent), one or two with the higher score representing greater expression of the feature. This change in scoring has led to the reduction of inter‐observer error with approximately 80% agreement for overall feature scores for both the common extensor origin and subscapularis insertion. The simplification of the scores and the reduction in inter‐observer error mean that the method is now recommended for widespread use. Copyright © 2015 John Wiley & Sons, Ltd.