Incorporation of the anteroposterior lumbar radiographs in the modified Stoke Ankylosing Spondylitis Spine Score improves detection of radiographic spinal progression in axial spondyloarthritis
Abstract Background To evaluate the performance of the extended modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) incorporating information from anteroposterior (AP) lumbar radiographs as compared to the conventional mSASSS in detection of radiographic spinal progression in patients with ax...
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BMC
2019-05-01
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| Series: | Arthritis Research & Therapy |
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| Online Access: | http://link.springer.com/article/10.1186/s13075-019-1913-z |
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| author | Maria Llop Valeria Rios Rodriguez Imke Redeker Joachim Sieper Hildrun Haibel Martin Rudwaleit Denis Poddubnyy |
| author_facet | Maria Llop Valeria Rios Rodriguez Imke Redeker Joachim Sieper Hildrun Haibel Martin Rudwaleit Denis Poddubnyy |
| author_sort | Maria Llop |
| collection | DOAJ |
| description | Abstract Background To evaluate the performance of the extended modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) incorporating information from anteroposterior (AP) lumbar radiographs as compared to the conventional mSASSS in detection of radiographic spinal progression in patients with axial spondyloarthritis (axSpA) Methods A total of 210 patients with axSpA, 115 with radiographic axSpA (r-axSpA), and 95 with non-radiographic axSpA (nr-axSpA), from the GErman SPondyloarthritis Inception Cohort (GESPIC), were included in the analysis based on the availability of spinal radiographs (cervical spine lateral, lumbar spine lateral, and AP views), at baseline and year 2. Two trained readers independently scored lateral cervical and lumbar spine images according to the mSASSS system (0–3 per vertebral corner, 0–72 in total). In addition, all vertebral corners of vertebral bodies visible on lumbar AP radiographs (lower T12 to upper S1) were assessed according to the same scoring system that resulted in a total range for the extended mSASSS from 0 to 144. Reliability and sensitivity to detect radiographic spinal progression of the extended mSASSS as compared to the conventional mSASSS were evaluated. Results The reliability of conventional and extended scores was excellent with intraclass correlation coefficients (ICCs) of 0.926 and 0.927 at baseline and 0.920 and 0.933 at year 2, respectively. The mean ± SD score for mSASSS and extended mSASSS at baseline were 4.25 ± 8.32 and 8.59 ± 17.96, respectively. The change score between baseline and year 2 was 0.73 ± 2.34 and 1.19 ± 3.73 for mSASSS and extended mSASSS, respectively. With the extended mSASSS, new syndesmophytes after 2 years were detected in 4 additional patients, new syndesmophytes or growth of existing syndesmophytes in 5 additional patients, and progression by ≥ 2 points in the total score in 14 additional patients meaning a 25%, 28%, and 46% increase in the proportion of patients with progression according to the respective definition as compared to the conventional score. Conclusions Incorporation of lumbar AP radiographs in the assessment of structural damage in the spine resulted into detection of additional patients with radiographic spinal progression not captured by the conventional mSASSS score. |
| first_indexed | 2024-12-11T01:55:45Z |
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| id | doaj.art-731ea45550f14df3aa614fa9d37579a2 |
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| last_indexed | 2024-12-11T01:55:45Z |
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| spelling | doaj.art-731ea45550f14df3aa614fa9d37579a22022-12-22T01:24:38ZengBMCArthritis Research & Therapy1478-63622019-05-012111910.1186/s13075-019-1913-zIncorporation of the anteroposterior lumbar radiographs in the modified Stoke Ankylosing Spondylitis Spine Score improves detection of radiographic spinal progression in axial spondyloarthritisMaria Llop0Valeria Rios Rodriguez1Imke Redeker2Joachim Sieper3Hildrun Haibel4Martin Rudwaleit5Denis Poddubnyy6Department of Gastroenterology, Infectious Diseases, and Rheumatology, Charité - Universitätsmedizin BerlinDepartment of Gastroenterology, Infectious Diseases, and Rheumatology, Charité - Universitätsmedizin BerlinDepartment of Gastroenterology, Infectious Diseases, and Rheumatology, Charité - Universitätsmedizin BerlinDepartment of Gastroenterology, Infectious Diseases, and Rheumatology, Charité - Universitätsmedizin BerlinDepartment of Gastroenterology, Infectious Diseases, and Rheumatology, Charité - Universitätsmedizin BerlinDepartment of Gastroenterology, Infectious Diseases, and Rheumatology, Charité - Universitätsmedizin BerlinDepartment of Gastroenterology, Infectious Diseases, and Rheumatology, Charité - Universitätsmedizin BerlinAbstract Background To evaluate the performance of the extended modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) incorporating information from anteroposterior (AP) lumbar radiographs as compared to the conventional mSASSS in detection of radiographic spinal progression in patients with axial spondyloarthritis (axSpA) Methods A total of 210 patients with axSpA, 115 with radiographic axSpA (r-axSpA), and 95 with non-radiographic axSpA (nr-axSpA), from the GErman SPondyloarthritis Inception Cohort (GESPIC), were included in the analysis based on the availability of spinal radiographs (cervical spine lateral, lumbar spine lateral, and AP views), at baseline and year 2. Two trained readers independently scored lateral cervical and lumbar spine images according to the mSASSS system (0–3 per vertebral corner, 0–72 in total). In addition, all vertebral corners of vertebral bodies visible on lumbar AP radiographs (lower T12 to upper S1) were assessed according to the same scoring system that resulted in a total range for the extended mSASSS from 0 to 144. Reliability and sensitivity to detect radiographic spinal progression of the extended mSASSS as compared to the conventional mSASSS were evaluated. Results The reliability of conventional and extended scores was excellent with intraclass correlation coefficients (ICCs) of 0.926 and 0.927 at baseline and 0.920 and 0.933 at year 2, respectively. The mean ± SD score for mSASSS and extended mSASSS at baseline were 4.25 ± 8.32 and 8.59 ± 17.96, respectively. The change score between baseline and year 2 was 0.73 ± 2.34 and 1.19 ± 3.73 for mSASSS and extended mSASSS, respectively. With the extended mSASSS, new syndesmophytes after 2 years were detected in 4 additional patients, new syndesmophytes or growth of existing syndesmophytes in 5 additional patients, and progression by ≥ 2 points in the total score in 14 additional patients meaning a 25%, 28%, and 46% increase in the proportion of patients with progression according to the respective definition as compared to the conventional score. Conclusions Incorporation of lumbar AP radiographs in the assessment of structural damage in the spine resulted into detection of additional patients with radiographic spinal progression not captured by the conventional mSASSS score.http://link.springer.com/article/10.1186/s13075-019-1913-zAxial spondyloarthritismSASSSRadiographic spinal progressionRadiographsX-rays |
| spellingShingle | Maria Llop Valeria Rios Rodriguez Imke Redeker Joachim Sieper Hildrun Haibel Martin Rudwaleit Denis Poddubnyy Incorporation of the anteroposterior lumbar radiographs in the modified Stoke Ankylosing Spondylitis Spine Score improves detection of radiographic spinal progression in axial spondyloarthritis Arthritis Research & Therapy Axial spondyloarthritis mSASSS Radiographic spinal progression Radiographs X-rays |
| title | Incorporation of the anteroposterior lumbar radiographs in the modified Stoke Ankylosing Spondylitis Spine Score improves detection of radiographic spinal progression in axial spondyloarthritis |
| title_full | Incorporation of the anteroposterior lumbar radiographs in the modified Stoke Ankylosing Spondylitis Spine Score improves detection of radiographic spinal progression in axial spondyloarthritis |
| title_fullStr | Incorporation of the anteroposterior lumbar radiographs in the modified Stoke Ankylosing Spondylitis Spine Score improves detection of radiographic spinal progression in axial spondyloarthritis |
| title_full_unstemmed | Incorporation of the anteroposterior lumbar radiographs in the modified Stoke Ankylosing Spondylitis Spine Score improves detection of radiographic spinal progression in axial spondyloarthritis |
| title_short | Incorporation of the anteroposterior lumbar radiographs in the modified Stoke Ankylosing Spondylitis Spine Score improves detection of radiographic spinal progression in axial spondyloarthritis |
| title_sort | incorporation of the anteroposterior lumbar radiographs in the modified stoke ankylosing spondylitis spine score improves detection of radiographic spinal progression in axial spondyloarthritis |
| topic | Axial spondyloarthritis mSASSS Radiographic spinal progression Radiographs X-rays |
| url | http://link.springer.com/article/10.1186/s13075-019-1913-z |
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