Imaging methods for evaluation of the structural changes in ankylosing spondylitis

Authors: A. Pudlač
Authors‘ workplace: Revmatologický ústav, Praha
Published in: Čes. Revmatol., 15, 2007, No. 2, p. 100-104.
Category: Overview Reports


Ankylosing spondylitis is an inflammatory disease characterized by wide spectrum of musculoskeletal manifestations. The disease affects particularly axial skeleton, adjacent ligaments and tendons. Plain radiography represents the gold standard in the assessment of progression of structural bone changes, calcifications and ossifications. Three different scoring systems evaluating x-ray findings are currently available – the Bath Ankylosing Spondylitis Radiology Index (BASRI), the Stoke Ankylosing Spondylitis Score (SASSS), and the modified Stoke Ankylosing Spondylitis Score (M-SASSS). Magnetic resonance imaging (MRI) is a key method to evaluate a soft tissue of spine. According to Braun scoring system, different sequences of MRI enable to measure acute and chronic changes. Scoring systems are used to evaluate the effect of the therapy on structural progression of the disease. Different imaging methods, scoring systems, and their contribution to clinical evaluation are also discussed in this review. Moreover, some results evaluating effect of the treatment on structural progression of the disease are mentioned.

Key words:
ankylosing spondylitis, evaluation of radiographic progression, evaluation of MRI progression, biologic treatment


1. Resnick D. Ankylosing spondylitis, In: Resnick D, eds. Bone and joint imaging. Philadelphia: W.B. Saunders, 1996; 246–264.

2. MacKay K, MACK C, Brophy S, Calin A. The Bath Ankylosing Spondylitis Radiology Index (BASRI): a new, validated approach to disease assessment. Arthritis Rheum 1998; 41: 2263–70.

3. Avers HL, Oxtobyx J, Tailor HG, Jones PW, Dziedzic K, Dawes PT. Radiological outcome in ankylosing spondylitis: use of the Stoke Ankylosing Spondylitis Score (SASSS). Br J Rheumatol 1996; 35: 373–6.

4. Creemers MC, Franssen MJ, van’t Hof MA, Gribnau FW, van de Putte LB, van Riel PL. A radiographic scoring systém and identification of variables measuring structural damane in ankylosing spondylitis (thesis). Nijmegen (The Neaderlands): University of Nijmegen; 1993.

5. Dale K. Radiographic gradings of sacroiliitis in Bechterew’s syndrome and allied disorders. Scand J Rheumatol 1979; 32 Suppl 32: 92–7.

6. Baraliakos X, Davis J, Tsuji W, Braun J. Magnetic resonance imaging examinations of the spine in patiens with ankylosing spondylitis before and after therapy with the tumor necrosis factor α receptor fusion protein etanercept. Arthritis Rheum 2005; 52: 1216–23.

7. Braun J, Baraliakos X, Golder W, et al. Magnetic resonance imaging examinations of the spine in patiens with ankylosing spondylitis before and after successful therapy with infliximab. Arthritis Rheum 2003; 48: 1126–36.

8. Braun J, Landewé R, Herman KG, et al. Major reduction in spinal inflammation in patiens with ankylosing spondylitis after treatment with infliximab. Arthritis Rheum 2006; 54: 1646–52.

9. Wanders AJ, Landawé RB, Spoorenberg A, et al. What is the most appropriate radiologic scoring method for ankylosing spondylitis? A comparison of the available methods based on the Outcome Measures in Rheumatology Clinical Trials filter. Arthritis Rheum 2004; Aug; 50(8): 2622–32.

10. MacKay K, Mack C, Brophy S,Mack C, Doran M, Calin A. The development and validation of radiographic grading system for the hip in ankylosing spondylitis: the Bath ankylosing spondylitis radiology hip index. J Rheumatol 2000; 27: 2866–72.

11. Taylor HG, Beswick EJ, Dawes PT. Sulphasalazine in ankylosing spondylitis: a radiological, clinical and laboratory assessment. Clin Rheumatol 1991; 10: 43–8.

12. Braun J, Baraliakos X, Golder W, et al. Analysing chronic spinal changes in ankylosing spondylitis: a systematic comparison of conventional x-rays with magnetic resonance imaging (MRI) using established and new scoring systéme. Ann Rheum Dis 2004; 63: 1046–55.

13. Braun J, van der Heijde D. Imaging and scoring in ankylosing spondylitis. Best Pract Res Clin Rheumatol 2002; 16: 573–604.

14. Wanders A, van der Heijde D, Landewé R, et al. Nonsteroidal antiinflammatory drugs reduce radiographic progresion in patiens with ankylosing spondylitis. Arthritis Rheum 2005; 52: 1756–65.

15. Boersma JW. Retardation of ossification of the lumbar vertebral column in ankylosing spondylitis by means of phenylbutazone. Scand J Rheumatol 1976; 5: 60–4.

Dermatology & STDs Paediatric rheumatology Rheumatology
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