RESEARCH - Association between radiographic damage of the spine and spinal mobility in ankylosing spondylitis

[Guest guest]

Ann Rheum Dis. 2005 Jul;64(7):988-94.

Association between radiographic damage of the spine and spinal mobility for

individual patients with ankylosing spondylitis: can assessment of spinal

mobility be a proxy for radiographic evaluation?

Wanders A, Landewe R, Dougados M, Mielants H, van der Linden S, van der

Heijde D.

University Hospital Maastricht, Department of Internal Medicine, Division of

Rheumatology, PO Box 5800, 6202 AZ Maastricht, The Netherlands.

OBJECTIVE: To demonstrate the association between various measures of spinal

mobility and radiographic damage of the spine in individual patients with

ankylosing spondylitis, and to determine whether the assessment of spinal

mobility can be a proxy for the assessment of radiographic damage. METHODS:

Radiographic damage was assessed by the mSASSS. Cumulative probability plots

combined the radiographic damage score of an individual patient with the

corresponding score for nine spinal mobility measures. Receiver operating

characteristic analysis was performed to determine the cut off level of

every spinal mobility measure that discriminates best between the presence

and absence of radiographic damage. Three arbitrary cut off levels for

radiographic damage were investigated. Likelihood ratios were calculated to

explore further the diagnostic properties of the spinal mobility measures.

RESULTS: Cumulative probability plots showed an association between spinal

mobility measures and radiographic damage for the individual patient.

Irrespective of the chosen cut off level for radiographic progression,

lateral spinal flexion and BASMI discriminated best between patients with

and those without structural damage. Even the best discriminatory spinal

mobility assessments misclassified a considerable proportion of patients (up

to 20%). Intermalleolar distance performed worst (up to 30%

misclassifications). Lateral spinal flexion best predicted the absence of

radiographic damage, and a modified Schober test best predicted the presence

of radiographic damage.

CONCLUSION: This study unequivocally demonstrated a relationship between

spinal mobility and radiographic damage. However, spinal mobility cannot be

used as a proxy for radiographic evaluation in an individual patient.

PMID: 15958757

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org