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Staging of patients with ankylosing spondylitis: a preliminary proposal
  1. J Braun1,
  2. D van der Heijde3,
  3. M Dougados4,
  4. P Emery5,
  5. M A Khan6,
  6. J Sieper2,
  7. Sj van der Linden3
  1. 1Rheumazentrum Ruhrgebiet, Herne, Germany and Department of Gastroenterology and Rheumatology, Free University, Berlin, Germany
  2. 2Department of Gastroenterology and Rheumatology, Free University, Berlin, Germany
  3. 3Department of Internal Medicine, Division of Rheumatology, University Hospital Maastricht, Maastricht, The Netherlands
  4. 4Department of Rheumatology, René Descartes University, Hôpital Cochin, Paris, France
  5. 5University of Cleveland, Cleveland, Ohio, USA
  6. 6School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
  1. Correspondence to:
    Professor J Braun, Rheumazentrum Ruhrgebiet, Landgrafenstr. 15, 44652 Herne, and UKBF, Free University, Berlin, Germany;


Patients with ankylosing spondylitis (AS) are characterised by a wide range of clinical presentations, radiographic profiles, and outcomes, which are not well differentiated by current diagnostic and classification systems for the disorder. Inadequacies in these systems may limit clinicians’ ability to manage their patients with AS appropriately and act as an obstacle to reasonable comparison of therapeutic trial results. A standardised staging system for AS is therefore proposed that would provide a more detailed categorisation of patients based on assessment of structural damage, peripheral joint and organ involvement, presence of concomitant diseases, and the severity and extent of disease activity and functional impairment. The proposed system needs to be evaluated closely and amended as needed to assure its usefulness in clinical and research settings.

  • ankylosing spondylitis
  • classification
  • diagnosis
  • staging
  • AS, ankylosing spondylitis
  • ASAS, Ankylosing Spondylitis Assessment (Working Group)
  • BASDAI, Bath AS Disease Activity Index
  • BASFI, Bath AS Functional Index
  • CRP, C reactive protein
  • DC-ART, disease controlling anti rheumatic treatment
  • DISH, diffuse idiopathic skeletal hyperostosis
  • ESSG, European Spondylarthropathy Study Group
  • HAQ, Health Assessment Questionnaire
  • IBD, inflammatory bowel disease
  • J, joint
  • MRI, magnetic resonance imaging
  • NSAID, non-steroidal antirheumatic drug
  • O, organ
  • Ps, psoriasis
  • RA, rheumatoid arthritis
  • ReA, reactive arthritis
  • SAPHO, synovitis, acne, pustulosis, hyperostosis, osteitis
  • SpA, spondyloarthropathy
  • TNF, tumour necrosis factor
  • uSpA, undifferentiated spondyloarthropathy

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