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. 2011 Jan;258(1):192-8.
doi: 10.1148/radiol.10100426. Epub 2010 Oct 22.

Ankylosing spondylitis: patterns of radiographic involvement--a re-examination of accepted principles in a cohort of 769 patients

Jennifer H Jang  1 , Michael M Ward, Adam N Rucker, John D Reveille, John C Davis Jr, Michael H Weisman, Thomas J Learch
Affiliations

Ankylosing spondylitis: patterns of radiographic involvement--a re-examination of accepted principles in a cohort of 769 patients

Jennifer H Jang et al. Radiology. 2011 Jan.

Abstract

Purpose: To re-examine the patterns of radiographic involvement in ankylosing spondylitis (AS).

Materials and methods: This prospective study had institutional review board approval, and 769 patients with AS (556 men, 213 women; mean age, 47.1 years; age range, 18-87 years) provided written informed consent. Radiographs of the cervical spine, lumbar spine, pelvis, and hips were scored by using the Bath Ankylosing Spondylitis Radiology Index (BASRI) by an experienced radiologist. Differences in sacroiliitis grade between right and left sacroiliac joints, frequency of cervical- and lumbar-predominant involvement by sex, frequency of progression to complete spinal fusion, and association between hip arthritis and spinal involvement were computed for the cohort overall and for subgroups defined according to duration of AS in 10-year increments.

Results: Symmetric sacroiliitis was seen in 86.1% of patients. Lumbar predominance was more common during the first 20 years of the disease, after which the cervical spine and lumbar spine were equally involved. Men and women were equally likely to have cervical-predominant involvement. Complete spinal fusion was observed in 27.9% of patients with AS for more than 30 years and in 42.6% of patients with AS for more than 40 years. Patients with BASRI hip scores of 2 or greater had significantly higher BASRI spine scores.

Conclusion: There were no sex differences in cervical-predominant involvement in AS. Hip arthritis was strongly associated with worse spinal involvement.

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Conflict of interest statement

Authors stated no financial relationship to disclose.

Figures

Figure 1:
Figure 1:
Lateral radiograph of lumbar spine in a patient with AS and a BASRI lumbar spine score of 2. Syndesmophytes are present anteriorly at the superior and inferior aspects of the L4 vertebral body.
Figure 2:
Figure 2:
Lateral radiograph of lumbar spine in a patient with AS and a BASRI lumbar spine score of 3. Bridging syndesmophytes are present anteriorly at L1 and L2. There are also nonbridging syndesmophytes at the anterior and superior aspects of L3.
Figure 3:
Figure 3:
Lateral radiograph of lumbar spine in a patient with AS and a BASRI lumbar spine score of 4 shows bridging syndesmophytes at multiple levels.
See this image and copyright information in PMC

References

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