{"id":319,"date":"2025-03-08T21:35:31","date_gmt":"2025-03-08T21:35:31","guid":{"rendered":"https:\/\/rheumanext.pl\/?page_id=319"},"modified":"2026-03-14T19:14:01","modified_gmt":"2026-03-14T19:14:01","slug":"zapalenie-wielomiesniowe-i-zapalenie-skorno-miesniowe-eular-acr-2017","status":"publish","type":"page","link":"https:\/\/rheumanext.pl\/pl\/kalkulatory\/kryteria\/zapalenie-wielomiesniowe-i-zapalenie-skorno-miesniowe-eular-acr-2017\/","title":{"rendered":"Zapalenie wielomi\u0119\u015bniowe (PM) oraz zapalenie sk\u00f3rno-mi\u0119\u015bniowe (DM) &#8211; EULAR\/ACR 2017"},"content":{"rendered":"\n<section id=\"rx-iim-eular-acr-2017-calculator\" style=\"max-width:960px;margin:0 auto;font:16px\/1.55 Inter,ui-sans-serif,system-ui,-apple-system,BlinkMacSystemFont,'Segoe UI',sans-serif;color:#0f172a;\">\n  <div style=\"background:linear-gradient(180deg,#ffffff 0%,#fbfdff 100%);border:1px solid #e2e8f0;border-radius:24px;box-shadow:0 12px 30px rgba(15,23,42,.06);overflow:hidden;\">\n    <div style=\"padding:28px 28px 20px;border-bottom:1px solid #e2e8f0;background:radial-gradient(circle at top right, rgba(15,118,110,.08), transparent 32%), linear-gradient(180deg,#ffffff 0%,#f8fafc 100%);\">\n      <div style=\"display:inline-block;padding:6px 12px;border-radius:999px;background:rgba(15,118,110,.10);color:#0f766e;font-size:12px;font-weight:700;letter-spacing:.02em;text-transform:uppercase;margin-bottom:14px;\">Kalkulator klasyfikacyjny<\/div>\n      <h2 style=\"margin:0 0 10px;font-size:clamp(24px,3vw,32px);line-height:1.15;letter-spacing:-.02em;\">Zapalenie wielomi\u0119\u015bniowe (PM) oraz zapalenie sk\u00f3rno-mi\u0119\u015bniowe (DM) \u2014 EULAR\/ACR 2017<\/h2>\n      <p style=\"margin:0;color:#475569;max-width:76ch;\">Formalnie s\u0105 to kryteria klasyfikacyjne dla idiopatycznych miopatii zapalnych (IIM) i ich g\u0142\u00f3wnych podtyp\u00f3w. Najpierw liczony jest wynik IIM, a nast\u0119pnie \u2014 je\u015bli pr\u00f3g klasyfikacyjny jest spe\u0142niony \u2014 wyznaczany jest najbardziej zgodny podtyp.<\/p>\n    <\/div>\n\n    <div style=\"padding:28px;display:grid;gap:20px;\">\n      <div style=\"background:#fff;border:1px solid #e2e8f0;border-radius:20px;padding:20px;\">\n        <h3 style=\"margin:0 0 6px;font-size:18px;\">1. Zastosowanie kryteri\u00f3w<\/h3>\n        <p style=\"margin:0 0 16px;color:#475569;font-size:14px;\">Kryteria stosuje si\u0119 wtedy, gdy nie ma lepszego wyja\u015bnienia objaw\u00f3w i oznak.<\/p>\n\n        <label style=\"display:flex;align-items:flex-start;gap:10px;padding:12px 14px;border:1px solid #e2e8f0;border-radius:16px;margin-bottom:10px;background:#fff;cursor:pointer;\">\n          <input type=\"radio\" name=\"rx-iim-entry\" id=\"rx-iim-entry-no\" value=\"no\" checked style=\"margin-top:3px;accent-color:#0f766e;\">\n          <span><strong>Nie<\/strong><br><span style=\"color:#475569;font-size:13px;\">istnieje lepsze rozpoznanie alternatywne<\/span><\/span>\n        <\/label>\n\n        <label style=\"display:flex;align-items:flex-start;gap:10px;padding:12px 14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n          <input type=\"radio\" name=\"rx-iim-entry\" id=\"rx-iim-entry-yes\" value=\"yes\" style=\"margin-top:3px;accent-color:#0f766e;\">\n          <span><strong>Tak<\/strong><br><span style=\"color:#475569;font-size:13px;\">objawy lepiej wyja\u015bnia inne rozpoznanie<\/span><\/span>\n        <\/label>\n      <\/div>\n\n      <div style=\"background:#fff;border:1px solid #e2e8f0;border-radius:20px;padding:20px;\">\n        <h3 style=\"margin:0 0 6px;font-size:18px;\">2. Wariant oceny<\/h3>\n        <p style=\"margin:0 0 16px;color:#475569;font-size:14px;\">Wybierz, czy chcesz liczy\u0107 model bez biopsji, czy z uwzgl\u0119dnieniem biopsji mi\u0119\u015bnia.<\/p>\n\n        <div style=\"display:grid;grid-template-columns:repeat(auto-fit,minmax(240px,1fr));gap:12px;\">\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"radio\" name=\"rx-iim-model\" id=\"rx-iim-model-no-biopsy\" value=\"no-biopsy\" checked style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Bez biopsji mi\u0119\u015bnia<\/strong><br><span style=\"color:#475569;font-size:13px;\">progi: possible \u22655,3 \u2022 probable \u22655,5 \u2022 definite \u22657,5<\/span><\/span>\n          <\/label>\n\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"radio\" name=\"rx-iim-model\" id=\"rx-iim-model-with-biopsy\" value=\"with-biopsy\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Z biopsj\u0105 mi\u0119\u015bnia<\/strong><br><span style=\"color:#475569;font-size:13px;\">progi: possible \u22656,5 \u2022 probable \u22656,7 \u2022 definite \u22658,7<\/span><\/span>\n          <\/label>\n        <\/div>\n      <\/div>\n\n      <div style=\"background:#fff;border:1px solid #e2e8f0;border-radius:20px;padding:20px;\">\n        <h3 style=\"margin:0 0 6px;font-size:18px;\">3. Wiek pocz\u0105tku choroby<\/h3>\n        <p style=\"margin:0 0 16px;color:#475569;font-size:14px;\">Wybierz jedn\u0105 kategori\u0119 wieku pocz\u0105tku pierwszego objawu zwi\u0105zanego z chorob\u0105.<\/p>\n\n        <div style=\"display:grid;grid-template-columns:repeat(auto-fit,minmax(240px,1fr));gap:12px;\">\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"radio\" name=\"rx-iim-age\" value=\"0\" data-with-biopsy=\"0\" checked style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>0\u201317 lat<\/strong><br><span style=\"color:#475569;font-size:13px;\">0 pkt<\/span><\/span>\n          <\/label>\n\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"radio\" name=\"rx-iim-age\" value=\"1.3\" data-with-biopsy=\"1.5\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>18\u201339 lat<\/strong><br><span style=\"color:#475569;font-size:13px;\">1,3 pkt bez biopsji \u2022 1,5 pkt z biopsj\u0105<\/span><\/span>\n          <\/label>\n\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"radio\" name=\"rx-iim-age\" value=\"2.1\" data-with-biopsy=\"2.2\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>\u226540 lat<\/strong><br><span style=\"color:#475569;font-size:13px;\">2,1 pkt bez biopsji \u2022 2,2 pkt z biopsj\u0105<\/span><\/span>\n          <\/label>\n        <\/div>\n      <\/div>\n\n      <div style=\"background:#fff;border:1px solid #e2e8f0;border-radius:20px;padding:20px;\">\n        <h3 style=\"margin:0 0 6px;font-size:18px;\">4. Os\u0142abienie mi\u0119\u015bni<\/h3>\n        <p style=\"margin:0 0 16px;color:#475569;font-size:14px;\">Zaznacz wszystkie obecne cechy os\u0142abienia mi\u0119\u015bni.<\/p>\n\n        <div style=\"display:grid;grid-template-columns:repeat(auto-fit,minmax(240px,1fr));gap:12px;\">\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-iim-upper\" data-no-biopsy=\"0.7\" data-with-biopsy=\"0.7\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Obiektywne symetryczne os\u0142abienie mi\u0119\u015bni proksymalnych ko\u0144czyn g\u00f3rnych<\/strong><br><span style=\"color:#475569;font-size:13px;\">0,7 pkt<\/span><\/span>\n          <\/label>\n\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-iim-lower\" data-no-biopsy=\"0.8\" data-with-biopsy=\"0.5\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Obiektywne symetryczne os\u0142abienie mi\u0119\u015bni proksymalnych ko\u0144czyn dolnych<\/strong><br><span style=\"color:#475569;font-size:13px;\">0,8 pkt bez biopsji \u2022 0,5 pkt z biopsj\u0105<\/span><\/span>\n          <\/label>\n\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-iim-neck\" data-no-biopsy=\"1.9\" data-with-biopsy=\"1.6\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Zginacze szyi s\u0142absze ni\u017c prostowniki<\/strong><br><span style=\"color:#475569;font-size:13px;\">1,9 pkt bez biopsji \u2022 1,6 pkt z biopsj\u0105<\/span><\/span>\n          <\/label>\n\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-iim-leg-pattern\" data-no-biopsy=\"0.9\" data-with-biopsy=\"1.2\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>W ko\u0144czynach dolnych mi\u0119\u015bnie proksymalne s\u0142absze ni\u017c dystalne<\/strong><br><span style=\"color:#475569;font-size:13px;\">0,9 pkt bez biopsji \u2022 1,2 pkt z biopsj\u0105<\/span><\/span>\n          <\/label>\n        <\/div>\n      <\/div>\n\n      <div style=\"background:#fff;border:1px solid #e2e8f0;border-radius:20px;padding:20px;\">\n        <h3 style=\"margin:0 0 6px;font-size:18px;\">5. Zmiany sk\u00f3rne charakterystyczne dla DM<\/h3>\n        <p style=\"margin:0 0 16px;color:#475569;font-size:14px;\">Zaznacz wszystkie obecne zmiany sk\u00f3rne.<\/p>\n\n        <div style=\"display:grid;grid-template-columns:repeat(auto-fit,minmax(240px,1fr));gap:12px;\">\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-iim-heliotrope\" data-no-biopsy=\"3.1\" data-with-biopsy=\"3.2\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Rumie\u0144 heliotropowy<\/strong><br><span style=\"color:#475569;font-size:13px;\">Heliotrope rash \u2022 3,1 \/ 3,2 pkt<\/span><\/span>\n          <\/label>\n\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-iim-gottron-papules\" data-no-biopsy=\"2.1\" data-with-biopsy=\"2.7\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Grudki Gottrona<\/strong><br><span style=\"color:#475569;font-size:13px;\">Gottron\u2019s papules \u2022 2,1 \/ 2,7 pkt<\/span><\/span>\n          <\/label>\n\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-iim-gottron-sign\" data-no-biopsy=\"3.3\" data-with-biopsy=\"3.7\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Objaw Gottrona<\/strong><br><span style=\"color:#475569;font-size:13px;\">Gottron\u2019s sign \u2022 3,3 \/ 3,7 pkt<\/span><\/span>\n          <\/label>\n        <\/div>\n      <\/div>\n\n      <div style=\"background:#fff;border:1px solid #e2e8f0;border-radius:20px;padding:20px;\">\n        <h3 style=\"margin:0 0 6px;font-size:18px;\">6. Inne objawy kliniczne i badania laboratoryjne<\/h3>\n        <p style=\"margin:0 0 16px;color:#475569;font-size:14px;\">Zaznacz wszystkie obecne cechy.<\/p>\n\n        <div style=\"display:grid;grid-template-columns:repeat(auto-fit,minmax(240px,1fr));gap:12px;\">\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-iim-dysphagia\" data-no-biopsy=\"0.7\" data-with-biopsy=\"0.6\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Dysfagia lub zaburzenia motoryki prze\u0142yku<\/strong><br><span style=\"color:#475569;font-size:13px;\">0,7 \/ 0,6 pkt<\/span><\/span>\n          <\/label>\n\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-iim-jo1\" data-no-biopsy=\"3.9\" data-with-biopsy=\"3.8\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Przeciwcia\u0142a anty-Jo-1 dodatnie<\/strong><br><span style=\"color:#475569;font-size:13px;\">3,9 \/ 3,8 pkt<\/span><\/span>\n          <\/label>\n\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-iim-enzymes\" data-no-biopsy=\"1.3\" data-with-biopsy=\"1.4\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Podwy\u017cszone enzymy mi\u0119\u015bniowe<\/strong><br><span style=\"color:#475569;font-size:13px;\">CK lub LDH lub AST lub ALT powy\u017cej normy \u2022 1,3 \/ 1,4 pkt<\/span><\/span>\n          <\/label>\n        <\/div>\n      <\/div>\n\n      <div style=\"background:#fff;border:1px solid #e2e8f0;border-radius:20px;padding:20px;\">\n        <h3 style=\"margin:0 0 6px;font-size:18px;\">7. Biopsja mi\u0119\u015bnia<\/h3>\n        <p style=\"margin:0 0 16px;color:#475569;font-size:14px;\">Te cechy licz\u0105 si\u0119 tylko wtedy, gdy wybrano wariant \u201ez biopsj\u0105 mi\u0119\u015bnia\u201d. \u201eRimmed vacuoles\u201d s\u0105 te\u017c u\u017cywane p\u00f3\u017aniej w podklasyfikacji IBM.<\/p>\n\n        <div style=\"display:grid;grid-template-columns:repeat(auto-fit,minmax(240px,1fr));gap:12px;\">\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-iim-biopsy-endomysial\" data-with-biopsy=\"1.7\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Endomysial infiltration<\/strong><br><span style=\"color:#475569;font-size:13px;\">kom\u00f3rki jednoj\u0105drzaste otaczaj\u0105 w\u0142\u00f3kna bez wyra\u017anej inwazji \u2022 1,7 pkt<\/span><\/span>\n          <\/label>\n\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-iim-biopsy-perimysial\" data-with-biopsy=\"1.2\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Perimysial \/ perivascular infiltration<\/strong><br><span style=\"color:#475569;font-size:13px;\">1,2 pkt<\/span><\/span>\n          <\/label>\n\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-iim-biopsy-perifascicular\" data-with-biopsy=\"1.9\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Perifascicular atrophy<\/strong><br><span style=\"color:#475569;font-size:13px;\">1,9 pkt<\/span><\/span>\n          <\/label>\n\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-iim-biopsy-rimmed\" data-with-biopsy=\"3.1\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Rimmed vacuoles<\/strong><br><span style=\"color:#475569;font-size:13px;\">3,1 pkt<\/span><\/span>\n          <\/label>\n        <\/div>\n      <\/div>\n\n      <div style=\"background:#fff;border:1px solid #e2e8f0;border-radius:20px;padding:20px;\">\n        <h3 style=\"margin:0 0 6px;font-size:18px;\">8. Dodatkowe elementy do podklasyfikacji<\/h3>\n        <p style=\"margin:0 0 16px;color:#475569;font-size:14px;\">Nie zwi\u0119kszaj\u0105 punktacji IIM. Pomagaj\u0105 rozr\u00f3\u017cni\u0107 podtyp ko\u0144cowy, zw\u0142aszcza IBM vs PM.<\/p>\n\n        <div style=\"display:grid;grid-template-columns:repeat(auto-fit,minmax(240px,1fr));gap:12px;\">\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-iim-ibm-clinical\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Os\u0142abienie zginaczy palc\u00f3w z brakiem poprawy po leczeniu<\/strong><br><span style=\"color:#475569;font-size:13px;\">u\u017cywane w drzewie klasyfikacyjnym IBM<\/span><\/span>\n          <\/label>\n        <\/div>\n      <\/div>\n\n      <div style=\"display:flex;flex-wrap:wrap;gap:12px;margin-top:2px;\">\n        <button\n          type=\"button\"\n          id=\"rx-iim-calc-btn\"\n          style=\"appearance:none;border:0;border-radius:16px;padding:14px 18px;background:linear-gradient(180deg,#0f766e 0%,#115e59 100%);color:#fff;font:inherit;font-weight:700;cursor:pointer;box-shadow:0 12px 24px rgba(15,118,110,.22);display:inline-flex;align-items:center;justify-content:center;min-width:180px;\"\n        >Oblicz wynik<\/button>\n\n        <button\n          type=\"button\"\n          id=\"rx-iim-clear-btn\"\n          style=\"appearance:none;border:1px solid #cbd5e1;border-radius:16px;padding:14px 18px;background:#fff;color:#0f172a;font:inherit;font-weight:700;cursor:pointer;display:inline-flex;align-items:center;justify-content:center;\"\n        >Wyczy\u015b\u0107<\/button>\n      <\/div>\n\n      <div id=\"rx-iim-result\" style=\"display:block;border-radius:20px;padding:20px;border:1px solid #e2e8f0;background:#f8fafc;\">\n        <p id=\"rx-iim-result-title\" style=\"margin:0 0 8px;font-size:18px;line-height:1.3;font-weight:800;color:#0f172a;\">Wynik pojawi si\u0119 tutaj<\/p>\n        <p id=\"rx-iim-result-text\" style=\"margin:0 0 8px;\">Zaznacz odpowiedzi, a nast\u0119pnie kliknij \u201eOblicz wynik\u201d.<\/p>\n        <p id=\"rx-iim-result-note\" style=\"margin:0;color:#475569;font-size:14px;\">Regu\u0142a: zsumuj punkty wed\u0142ug modelu bez biopsji lub z biopsj\u0105. Nast\u0119pnie przypisz kategori\u0119 IIM i \u2014 je\u015bli pr\u00f3g klasyfikacyjny jest spe\u0142niony \u2014 najbardziej zgodny podtyp.<\/p>\n      <\/div>\n\n      <div style=\"border:1px solid #e2e8f0;background:linear-gradient(180deg,#ffffff 0%,#f8fafc 100%);border-radius:18px;padding:16px 18px;color:#475569;font-size:14px;\">\n        <strong style=\"color:#0f172a;\">Uwaga:<\/strong> to narz\u0119dzie wspiera klasyfikacj\u0119 idiopatycznych miopatii zapalnych i ich podtyp\u00f3w. Kryteria klasyfikacyjne nie s\u0105 samodzielnym narz\u0119dziem diagnostycznym. W przypadku braku patognomonicznych zmian sk\u00f3rnych DM interpretacja bez biopsji wymaga szczeg\u00f3lnej ostro\u017cno\u015bci. Edukacyjnie. Nie zast\u0119puje konsultacji lekarskiej.\n      <\/div>\n    <\/div>\n  <\/div>\n<\/section>\n\n<script>\n(function () {\n  var calcBtn = document.getElementById('rx-iim-calc-btn');\n  var clearBtn = document.getElementById('rx-iim-clear-btn');\n\n  if (!calcBtn || !clearBtn) return;\n\n  function selectedValue(name, attrNo, attrWith) {\n    var selected = document.querySelector('input[name=\"' + name + '\"]:checked');\n    if (!selected) return 0;\n    var withBiopsy = document.getElementById('rx-iim-model-with-biopsy').checked;\n    return parseFloat(withBiopsy ? (selected.getAttribute(attrWith) || selected.getAttribute('value') || '0') : (selected.getAttribute(attrNo) || selected.getAttribute('value') || '0'));\n  }\n\n  function checkboxValue(id) {\n    var el = document.getElementById(id);\n    if (!el || !el.checked) return 0;\n    var withBiopsy = document.getElementById('rx-iim-model-with-biopsy').checked;\n    return parseFloat(withBiopsy ? (el.getAttribute('data-with-biopsy') || '0') : (el.getAttribute('data-no-biopsy') || '0'));\n  }\n\n  function isChecked(id) {\n    var el = document.getElementById(id);\n    return !!(el && el.checked);\n  }\n\n  function classifyLevel(score, withBiopsy) {\n    if (withBiopsy) {\n      if (score >= 8.7) return 'definite';\n      if (score >= 6.7) return 'probable';\n      if (score >= 6.5) return 'possible';\n      return 'no';\n    } else {\n      if (score >= 7.5) return 'definite';\n      if (score >= 5.5) return 'probable';\n      if (score >= 5.3) return 'possible';\n      return 'no';\n    }\n  }\n\n  function formatScore(num) {\n    return (Math.round(num * 10) \/ 10).toFixed(1).replace('.', ',');\n  }\n\n  calcBtn.addEventListener('click', function () {\n    var noBetterExplanation = document.getElementById('rx-iim-entry-no').checked;\n    var withBiopsy = document.getElementById('rx-iim-model-with-biopsy').checked;\n\n    var result = document.getElementById('rx-iim-result');\n    var title = document.getElementById('rx-iim-result-title');\n    var text = document.getElementById('rx-iim-result-text');\n    var note = document.getElementById('rx-iim-result-note');\n\n    result.style.display = 'block';\n\n    if (!noBetterExplanation) {\n      result.style.background = '#fef2f2';\n      result.style.border = '1px solid #fecaca';\n      title.style.color = '#991b1b';\n      title.innerHTML = 'Kryteria nie maj\u0105 zastosowania';\n      text.innerHTML = 'Objawy s\u0105 lepiej wyja\u015bnione przez inne rozpoznanie.';\n      note.innerHTML = 'Kryteria EULAR\/ACR 2017 dla IIM stosuje si\u0119 wtedy, gdy nie ma lepszego wyja\u015bnienia dla objaw\u00f3w i oznak.';\n      return;\n    }\n\n    var score = 0;\n    var components = [];\n\n    score += selectedValue('rx-iim-age', 'value', 'data-with-biopsy');\n    if (score > 0) {\n      var ageSelected = document.querySelector('input[name=\"rx-iim-age\"]:checked');\n      if (ageSelected && ageSelected.value !== '0') components.push('wiek pocz\u0105tku choroby');\n    }\n\n    var weightedCheckboxes = [\n      ['rx-iim-upper', 'os\u0142abienie proksymalnych mi\u0119\u015bni ko\u0144czyn g\u00f3rnych'],\n      ['rx-iim-lower', 'os\u0142abienie proksymalnych mi\u0119\u015bni ko\u0144czyn dolnych'],\n      ['rx-iim-neck', 'zginacze szyi s\u0142absze ni\u017c prostowniki'],\n      ['rx-iim-leg-pattern', 'proksymalne mi\u0119\u015bnie n\u00f3g s\u0142absze ni\u017c dystalne'],\n      ['rx-iim-heliotrope', 'rumie\u0144 heliotropowy'],\n      ['rx-iim-gottron-papules', 'grudki Gottrona'],\n      ['rx-iim-gottron-sign', 'objaw Gottrona'],\n      ['rx-iim-dysphagia', 'dysfagia \/ zaburzenia motoryki prze\u0142yku'],\n      ['rx-iim-jo1', 'anty-Jo-1'],\n      ['rx-iim-enzymes', 'podwy\u017cszone enzymy mi\u0119\u015bniowe'],\n      ['rx-iim-biopsy-endomysial', 'endomysial infiltration'],\n      ['rx-iim-biopsy-perimysial', 'perimysial \/ perivascular infiltration'],\n      ['rx-iim-biopsy-perifascicular', 'perifascicular atrophy'],\n      ['rx-iim-biopsy-rimmed', 'rimmed vacuoles']\n    ];\n\n    weightedCheckboxes.forEach(function (item) {\n      var val = checkboxValue(item[0]);\n      if (val) {\n        score += val;\n        components.push(item[1]);\n      }\n    });\n\n    var level = classifyLevel(score, withBiopsy);\n\n    var hasRash = isChecked('rx-iim-heliotrope') || isChecked('rx-iim-gottron-papules') || isChecked('rx-iim-gottron-sign');\n    var hasWeakness = isChecked('rx-iim-upper') || isChecked('rx-iim-lower') || isChecked('rx-iim-neck') || isChecked('rx-iim-leg-pattern');\n    var juvenile = document.querySelector('input[name=\"rx-iim-age\"]:checked').value === '0';\n    var ibmClinical = isChecked('rx-iim-ibm-clinical');\n    var rimmed = isChecked('rx-iim-biopsy-rimmed');\n\n    var subtype = '';\n    if (level === 'probable' || level === 'definite') {\n      if (juvenile) {\n        subtype = hasRash ? 'JDM' : 'm\u0142odzie\u0144cze zapalenie mi\u0119\u015bni inne ni\u017c JDM';\n      } else {\n        if (hasRash) {\n          subtype = hasWeakness ? 'DM' : 'ADM';\n        } else {\n          subtype = (ibmClinical || rimmed) ? 'IBM' : 'PM (obejmuje te\u017c IMNM)';\n        }\n      }\n    }\n\n    var categoryLabel = '';\n    if (level === 'definite') categoryLabel = 'definite IIM';\n    if (level === 'probable') categoryLabel = 'probable IIM';\n    if (level === 'possible') categoryLabel = 'possible IIM';\n\n    var thresholdText = withBiopsy\n      ? 'progi z biopsj\u0105: possible \u22656,5 \u2022 probable \u22656,7 \u2022 definite \u22658,7'\n      : 'progi bez biopsji: possible \u22655,3 \u2022 probable \u22655,5 \u2022 definite \u22657,5';\n\n    var caution = '';\n    if (!withBiopsy && !hasRash) {\n      caution = ' Uwaga interpretacyjna: przy braku patognomonicznych zmian sk\u00f3rnych w publikacji rekomendowano rozwa\u017cenie biopsji mi\u0119\u015bnia.';\n    }\n\n    if (level === 'no') {\n      result.style.background = '#fffbeb';\n      result.style.border = '1px solid #fde68a';\n      title.style.color = '#92400e';\n      title.innerHTML = 'Kryteria niespe\u0142nione';\n      text.innerHTML = 'Wynik nie osi\u0105ga progu klasyfikacyjnego dla idiopatycznych miopatii zapalnych.';\n      note.innerHTML = 'Suma punkt\u00f3w: ' + formatScore(score) + '. Model: ' + (withBiopsy ? 'z biopsj\u0105 mi\u0119\u015bnia' : 'bez biopsji') + '; ' + thresholdText + '.' + (components.length ? ' Zaznaczone elementy: ' + components.join(', ') + '.' : '') + caution;\n      return;\n    }\n\n    if (level === 'possible') {\n      result.style.background = '#fffbeb';\n      result.style.border = '1px solid #fde68a';\n      title.style.color = '#92400e';\n      title.innerHTML = 'Possible IIM';\n      text.innerHTML = 'Wynik mie\u015bci si\u0119 w przedziale \u201epossible IIM\u201d. To za ma\u0142o do zalecanej klasyfikacji IIM wed\u0142ug progu \u226555%.';\n      note.innerHTML = 'Suma punkt\u00f3w: ' + formatScore(score) + '. Model: ' + (withBiopsy ? 'z biopsj\u0105 mi\u0119\u015bnia' : 'bez biopsji') + '; ' + thresholdText + '.' + (components.length ? ' Zaznaczone elementy: ' + components.join(', ') + '.' : '') + caution;\n      return;\n    }\n\n    result.style.background = '#f0fdf4';\n    result.style.border = '1px solid #bbf7d0';\n    title.style.color = '#166534';\n    title.innerHTML = 'Kryteria spe\u0142nione';\n\n    if (subtype) {\n      text.innerHTML = 'Spe\u0142niono kryteria EULAR\/ACR 2017 dla IIM. Najbardziej zgodny podtyp: <strong>' + subtype + '<\/strong>.';\n    } else {\n      text.innerHTML = 'Spe\u0142niono kryteria EULAR\/ACR 2017 dla IIM.';\n    }\n\n    note.innerHTML = 'Kategoria: ' + categoryLabel + '. Suma punkt\u00f3w: ' + formatScore(score) + '. Model: ' + (withBiopsy ? 'z biopsj\u0105 mi\u0119\u015bnia' : 'bez biopsji') + '; ' + thresholdText + '.' + (components.length ? ' Zaznaczone elementy: ' + components.join(', ') + '.' : '') + caution;\n  });\n\n  clearBtn.addEventListener('click', function () {\n    document.getElementById('rx-iim-entry-no').checked = true;\n    document.getElementById('rx-iim-model-no-biopsy').checked = true;\n    document.querySelector('input[name=\"rx-iim-age\"][value=\"0\"]').checked = true;\n\n    [\n      'rx-iim-upper',\n      'rx-iim-lower',\n      'rx-iim-neck',\n      'rx-iim-leg-pattern',\n      'rx-iim-heliotrope',\n      'rx-iim-gottron-papules',\n      'rx-iim-gottron-sign',\n      'rx-iim-dysphagia',\n      'rx-iim-jo1',\n      'rx-iim-enzymes',\n      'rx-iim-biopsy-endomysial',\n      'rx-iim-biopsy-perimysial',\n      'rx-iim-biopsy-perifascicular',\n      'rx-iim-biopsy-rimmed',\n      'rx-iim-ibm-clinical'\n    ].forEach(function (id) {\n      document.getElementById(id).checked = false;\n    });\n\n    document.getElementById('rx-iim-result').style.display = 'block';\n    document.getElementById('rx-iim-result').style.background = '#f8fafc';\n    document.getElementById('rx-iim-result').style.border = '1px solid #e2e8f0';\n    document.getElementById('rx-iim-result-title').style.color = '#0f172a';\n    document.getElementById('rx-iim-result-title').innerHTML = 'Wynik pojawi si\u0119 tutaj';\n    document.getElementById('rx-iim-result-text').innerHTML = 'Zaznacz odpowiedzi, a nast\u0119pnie kliknij \u201eOblicz wynik\u201d.';\n    document.getElementById('rx-iim-result-note').innerHTML = 'Regu\u0142a: zsumuj punkty wed\u0142ug modelu bez biopsji lub z biopsj\u0105. Nast\u0119pnie przypisz kategori\u0119 IIM i \u2014 je\u015bli pr\u00f3g klasyfikacyjny jest spe\u0142niony \u2014 najbardziej zgodny podtyp.';\n  });\n})();\n<\/script>\n\n","protected":false},"excerpt":{"rendered":"<p>Kalkulator klasyfikacyjny Zapalenie wielomi\u0119\u015bniowe (PM) oraz zapalenie sk\u00f3rno-mi\u0119\u015bniowe (DM) \u2014 EULAR\/ACR 2017 Formalnie s\u0105 to kryteria klasyfikacyjne dla idiopatycznych miopatii zapalnych (IIM) i ich g\u0142\u00f3wnych podtyp\u00f3w. Najpierw liczony jest wynik IIM, a nast\u0119pnie \u2014 je\u015bli pr\u00f3g klasyfikacyjny jest spe\u0142niony \u2014 wyznaczany jest najbardziej zgodny podtyp. 1. Zastosowanie kryteri\u00f3w Kryteria stosuje si\u0119 wtedy, gdy nie ma&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":980,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"_kadence_starter_templates_imported_post":false,"_kad_post_transparent":"","_kad_post_title":"","_kad_post_layout":"","_kad_post_sidebar_id":"","_kad_post_content_style":"","_kad_post_vertical_padding":"","_kad_post_feature":"","_kad_post_feature_position":"","_kad_post_header":false,"_kad_post_footer":false,"_kad_post_classname":"","footnotes":""},"class_list":["post-319","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/rheumanext.pl\/pl\/wp-json\/wp\/v2\/pages\/319","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/rheumanext.pl\/pl\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/rheumanext.pl\/pl\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/rheumanext.pl\/pl\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/rheumanext.pl\/pl\/wp-json\/wp\/v2\/comments?post=319"}],"version-history":[{"count":4,"href":"https:\/\/rheumanext.pl\/pl\/wp-json\/wp\/v2\/pages\/319\/revisions"}],"predecessor-version":[{"id":1145,"href":"https:\/\/rheumanext.pl\/pl\/wp-json\/wp\/v2\/pages\/319\/revisions\/1145"}],"up":[{"embeddable":true,"href":"https:\/\/rheumanext.pl\/pl\/wp-json\/wp\/v2\/pages\/980"}],"wp:attachment":[{"href":"https:\/\/rheumanext.pl\/pl\/wp-json\/wp\/v2\/media?parent=319"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}