Background For assessing structural damage in AS on spinal X-rays Bath Ankylosing Spondylitis Radiology Index (BASRI) and modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) scoring systems can be used
Objectives To present the prevalence of abnormalities based on the BASRI and mSASSS in patients (pts) with recent inflammatory back pain (IBP) and to compare these 2 scores
Methods Pts aged 18-50 with recent IBP (≥3 months, ≤3 years) from 25 participating centres in France were included in the DESIR (Devenir des Spondylarthropathies Indifferenciées Récentes)-cohort (n=708). Available baseline spinal X-rays (cervical and lumbar) were scored by 2 well-calibrated central readers independently, blinded for clinical data. When readers disagreed, an experienced radiologist served as adjudicator. BASRI and mSASSS were calculated from the mean of the scores of the 2 readers (and adjudicator if applicable). Pts were classified according to the ASAS axial SpondyloArthritis (ASAS axSpA) criteria into pts fulfilling the imaging arm, either fulfilling or not fulfilling the modified New York (mNY) criteria, fulfilling the clinical arm and not fulfilling (no-axSpA pts) the criteria
Results Pts with complete X-ray data (n=599) were included in these analyses. Overall, 559 pts (93.3%) had no definite abnormalities assessed by mSASSS <2, and 564 (94.2%) by BASRI <2; 93.0% and 93.5% within the ASAS axSpA group (n=431), respectively (see table). A BASRI of ≥2 was scored more frequently in the imaging arm compared to the clinical arm and no-axSpA pts (table). When comparing mSASSS and BASRI readings, using a cut-off of ≥2 (definite abnormalities) for both scoring methods, we found a very high percentage of agreement in all the different patient groups: range 95.4% to 98.2%. Only in few pts syndesmophytes were found (table). More syndesmophytes were present in cervical spine than in lumbar spine. The number of syndesmophytes in cervical vs lumbar spine was 6 vs 3 in the no-axSpA group, 6 vs 1 in the clinical arm, 5 vs 1 in the imaging mNY-group, and 8 vs 1 in the imaging mNY+ group
Conclusions The agreement between mSASSS and BASRI ≥2 is very high in all groups. Abnormalities typical for AS such as syndesmophytes are generally infrequent in this early cohort, but if observed, syndesmophytes are more frequent in the cervical spine compared to the lumbar spine. An mSASSS and BASRI of ≥2 is more often seen in pts fulfilling the ASAS classification criteria compared to no-SpA pts
Disclosure of Interest None declared
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.