In this paper, a measurement method for the distance between binary objects will be presented. It has been developed for a specific purpose, the evaluation of rheumatic disease, but should be useful also in other applications. It is based on a distance map in the area between binary objects. A skeleton is extracted from the distance map by searching for local maxima. The distance measure is based on the average of skelton points in a defined measurement area. An objective criterion for selection of measurement points on the skeleton is proposed. Preliminary results indicate that good repeatability is attained.