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SAT0012 The relationship between spinal, sacroiliac involvement and functional assessment in ankylosing spondylitis
  1. F Özdemýr1,
  2. K Uzunca1,
  3. S Kokino1,
  4. S Erdogan2
  1. 1Physical Medicine and Rehabilitation, Trakya University, Edýrne
  2. 2Public Health, Kocaeli University, Kocaeli-Izmit, Turkey


Background Ankylosing Spondylitis (AS) is a chronic destructive and deforming joint disease that affects both axial and peripheral joints. The relationship between the radiological changes of the joint disease and its functional consequences is important. Because sacroiliac joint abnormalities and spinal ligamentous calcification and ossification, syndesmophytes, osseous fusion may be caused clinical manifestations and disability.

Objectives The aim of the present study was to evaluate the correlation existing between the radiological progression of the disease and functional impairment in AS.

Methods 36 patients with clinically and radiologically verified AS were recruited to participate in the study.

All patients had standard anteroposterior, lateral lumbar spine radiography and Ferguson views of the sacroiliac joints.

A global grading system including sacroiliac joints (New York Criteria) and a detailed scoring system of the lumbar spine (Stoke Ankylosing Spondylitis Spine Score (SASSS)) were used to assess structural damage.

Functional impairment was assessed by the Bath Ankylosing Spondylitis functional index (BASFI). The BASFI consists of eight items on daily activities and two items assessing the patients? ability o deal with their everyday life. BASFI are validated and widely used instruments to assess physical function in patients with AS.

We correlated the BASFI with radiographic damage measures.

Results The sacroiliac scores were on range of 2–4 according to New York criteria (mean = 2.0 ± 0.73). Lumbar spine radiographic scores were on range of 7 ? 40 according to SASSS (mean = 19.4 ± 8.07).

Functional index correlated with the damage measures of lumbar spine (r = 0.43, p = 0.01). However no significant difference was noted between functional impairment and sacroiliac involvement (x2 = 2.6, p = 0.27).

Conclusion Ascending spinal involvement showed more related to change of functional impairment than damage of sacroiliac joints.


  1. Calin A, Garret S, Whitlock H, Kennedy LG, Mallorie P. A new approach to defining functional ability in ankylosing spondylitis: the development of the bath ankylosing spondylitis functional index. J Rheumatol. 1994;21(12):2281–5

  2. Dougados M, Van der Heijde D. Evaluation of functional capacity in ankylosing spondylitis. J Rheumatol. 1999;26(1):4–6

  3. Brower AC. Spondyloarthropaties imaging. In: Klippel JH, Dippe PA, eds. Rheumatology, 2nd edn. Vol. 1. Chapter 6.17. London: Mosby, 1998: 1–8

  4. Oostven J, Prevo R, Boer J, Laar M. Early detection of sacroileitis on magnetic resonance imaging and subsequent development of sacroileitis on plain radiography. A prospective, longitudinal study. J Rheumatol. 1999;26(9):1953–8

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