<p><em><strong>None</strong> = No swelling.</em></p>
<p><em><strong>Puffy</strong> = The joint swelling looks slightly “puffy” (slightly full).</em></p>
<p><em><strong>Spongy</strong> = There is an obvious spongy feel to the swelling.</em></p>
<p><em><strong>Tense</strong> = The joint looks very swollen, is tense or spongy, and bony landmarks are fully obscured.</em></p>