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Abstract
Background Ankylosing Spondylitis is characterized by axial involvement, especially of sacroiliacs and the vertebral bodies, although we also know that other such as facet joints (Fj) are affected. These joints can be seen with a simple x-ray, especially in the cervical spine. Despite their involvement, the different rates of radiographic progression do not assess their alteration.
Objectives To evaluate the sensitivity to the change of the m-SASSS radiographic score by including the assessment of the cervical Fj.
Methods The patients come from a Spondyloarthritis Unit (Hospital U. Virgen de la Arrixaca de Murcia, Spain). All patients are diagnosed of Ankylosing Spondylitis (New York Modified Criteria)
The usual radiographic study was performed to calculate the m-SASSS and a lateral cervical radiograph at two different times to calculate the difference between the scores. The score used for Fj (only one score is given for each intervertebral segment) is:
– 0: normal.
– 1: pinching (narrowing of joint space).
– 2: sclerosis in the joint margins.
– 3: joint fusion.
We will analyze the mean of the two m-SASSS radiographic score, with (m-SASSS + Fj) and without the inclusion of the Fj, and the difference between those means. We will also analyze the correlation with the rest of the radiographic scores and with the clinical patient's parameters.
Results We included 47 patients (81% male and 19% female) with a mean age of 48 (± 8) years and a mean duration of symptoms of 18 (± 8.5) years. The mean time between the two radiographic studies was 3 (± 1.5) years.
In the following table we show the difference of means of the radiographic scores over time:
After comparing Δ mSASSS with Δ mSASSS+Fj, we found significant differences in favor of inclusion: 2.6 (± 2) vs 4.9 (± 4.7), p=0.04.
Conclusions The inclusion of the evaluation of cervical Fj improves sensitivity to change of m-SASSS.
References
Averns HL, Oxtoby J, Taylor HG, Jones PW, Dziedzic K, Dawes PT. Radiological outcome in ankylosing spondylitis: use of the Stoke Ankylosing Spondylitis Spine Score (SASSS). Rheumatology.1996;35(4):373–376.
Bleil J, Maier R, Hempfing A, Schlichting U, Appel H, Sieper J, et al. Histomorphologic and Histomorphometric Characteristics of Zygapophyseal Joint Remodeling in Ankylosing Spondylitis: Histomorphometric Characteristics of the Joints of AS Patients. Arthritis Rheumatol.2014;66(7):1745–1754.
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Disclosure of Interest None declared