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Neutral lateral fingertip-to-floor distance can be derived from height
  1. Sofia Ramiro1,2,
  2. Astrid van Tubergen3,4,
  3. Carmen Stolwijk3,4,
  4. Désirée van der Heijde5,
  5. Robert Landewé1,6
  1. 1Department of Clinical Immunology & Rheumatology, Amsterdam Rheumatology Center, University of Amsterdam, Amsterdam, The Netherlands
  2. 2Department of Rheumatology, Hospital Garcia de Orta, Almada, Portugal
  3. 3Department of Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands
  4. 4School for Public Health and Primary Care (CAPHRI), University of Maastricht, Maastricht, The Netherlands
  5. 5Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  6. 6Department of Rheumatology, Atrium Medical Center, Heerlen, The Netherlands
  1. Correspondence to Dr Sofia Ramiro, Department of Clinical Immunology & Rheumatology, Amsterdam Rheumatology Center, University of Amsterdam, Amsterdam 1100DD, The Netherlands; sofiaramiro{at}

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Spinal mobility is one of the core outcome measures used in axial spondyloarthritis as recommended by the Assessment of SpondyloArthritis international Society (ASAS).1 ,2 Among the commonly used spinal mobility measures, lateral spinal flexion (LSF) is considered to be the most sensitive to change and has therefore been included as one of the domains in the ASAS 5/6 response criteria.3 ,4

LSF is measured as the difference between two marks placed on the thigh, one in a neutral standing position and the other in maximum lateral flexion.2 Alternatively, LSF can be calculated as the difference in the lateral distances between middle fingertip-to-floor (FTF) in the neutral position (neutral FTF) and middle FTF in maximum latero-flexion (maximum flexion FTF).2 In this second LSF measurement, it may sometimes erroneously and accidentally happen that …

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