Ankylosing spondylitisFactors Associated with Radiographic Spinal Involvement and Hip Involvement in Ankylosing Spondylitis
Section snippets
Patients and Clinical Assessments
We consecutively enrolled 531 patients from our rheumatology outpatient clinics. All patients had a complete set of radiographs and met the 1984 modified New York criteria for definite AS (2). For each patient, we recorded age, gender, age at disease onset, disease duration, main features, the presence of HLA-B27 antigen, and treatment. No biological agents had been used in these patients. The main features were reviewed retrospectively by clinical history and/or medical records; features
Characteristics of Patients Based on the Different Types of Radiographically Seen Damage in the Spine
Table 1 describes the disease-related characteristics of the AS patients according to the radiographic involvement in the spine. Ninety-eight (18.5%) patients had spinal involvement with fusion, 142 (26.7%) had spinal involvement without fusion, and 291 (54.8%) had no spinal involvement, using the mSASSS definition. Patients with spinal abnormalities on radiography were more frequently male and were more likely to have hip disease, an enthesitis history, and a reduced ability to exercise. No
Discussion
In this study, we investigated the factors associated with radiographic evidence of spinal fusion and hip involvement in patients with AS. Radiographic imaging is an objective measurement to assess disease severity and outcome. It was not surprising that disease duration was an important factor associated with spinal fusion. An elevated CRP level, advanced radiographic sacroiliitis, and hip involvement were the predictors for development of spinal fusion, and the former 2 were also the
Acknowledgments
The authors would like to thank the participants and staff who contributed to the study.
References (22)
- et al.
Ankylosing spondylitis
Lancet
(2007) - et al.
Differences between juvenile-onset ankylosing spondylitis and adult-onset ankylosing spondylitis
J Chin Med Assoc
(2009) - et al.
Evaluation of diagnostic criteria for ankylosing spondylitisA proposal for modification of the New York criteria
Arthritis Rheum
(1984) - et al.
The natural history of ankylosing spondylitis as defined by radiological progression
J Rheumatol
(2002) - et al.
The natural course of radiographic progression in ankylosing spondylitis—evidence for major individual variations in a large proportion of patients
J Rheumatol
(2009) - et al.
Spinal radiographic changes in ankylosing spondylitis: association with clinical characteristics and functional outcome
J Rheumatol
(2009) - et al.
The early disease stage in axial spondylarthritis: results from the German Spondyloarthritis Inception Cohort
Arthritis Rheum
(2009) - et al.
Hip involvement in ankylosing spondylitis: epidemiology and risk factors associated with hip replacement surgery
Rheumatology (Oxford)
(2010) - et al.
Clinical, radiographic and functional differences between juvenile-onset and adult-onset ankylosing spondylitis: results from the PSOAS cohort
Ann Rheum Dis
(2008) - et al.
Prevalence of rheumatic diseases in Taiwan: a population study of urban, suburban, rural differences
J Rheumatol
(1994)
Clinical history as a screening test for ankylosing spondylitis
JAMA
Cited by (68)
Revision total hip arthroplasty in patients with ankylosing spondylitis: Mid-term results
2023, Orthopaedics and Traumatology: Surgery and ResearchCitation Excerpt :First, the young age for many patients with AS upon primary THA increases the chance of subsequent revision. Second, spinal-pelvic rigidity and deformity are often at a more advanced stage in these patients [19]. Studies have found that spinal-pelvic ankylosis caused by disease or surgery, alters the spinal pelvic motion and may potentially position the acetabular cup out of the functional safe zone [20,21].
Sacroiliac joint fusion in patients with ankylosing spondylitis is associated with hip involvement
2023, Journal of Orthopaedic ScienceCardiovascular and disease-related features associated with extra-articular manifestations in axial spondyloarthritis. A multicenter study of 888 patients
2022, Seminars in Arthritis and RheumatismCitation Excerpt :As far as we are concerned, a higher degree of sacroiliitis, a feature of disease severity correlated with cumulative inflammation [45] and osteoporotic fracture risk [46], has not been reported in these patients so far, while studies analyzing radiographic spinal changes have yielded conflicting results. A cross-sectional study with 311 AS patients also found an association between AAU and radiographic damage measured by BASRI [22], whereas another cross-sectional study including 531 Taiwanese AS patients [21] and a longitudinal study conducted in the OASIS cohort [17] failed to demonstrate such a link. As expected, the prevalence of HLA B27 was higher in axSpA patients with concurrent AAU (82% versus 70%, p = 0.000).
Primary Total Hip Arthroplasty in Patients With Ankylosing Spondylitis
2021, Journal of ArthroplastyRevision Total Hip Arthroplasty in Patients With Ankylosing Spondylitis: Long-Term Results
2020, Journal of Arthroplasty
This study was funded by the National Science Council of Taiwan and Taipei Veterans General Hospital.
The authors have no conflicts of interest to disclose.