Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement

The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.

Associations with Radiographic Damage in Ankylosing Spondylitis in a Large Cohort

O'Shea,  Finbar (Barry) D., Haroon,  Nigil, Riarh,  Reena, Inman,  R.D.


To study the radiographic damage in a large ankylosing spondyltis (AS) in relation to multiple clinical parameters using the modified Stoke AS Spinal Score (mSASSS).


The patients were drawn from the clinical database of the Spondylitis Clinic in a large teaching hospital. Patients are evaluated according to a standard protocol in which demographic, clinical, radiographic and laboratory variables are recorded at regular intervals. Mean and standard deviation (SD) were calculated for the various clinical variables. The mSASSS was correlated with the grade of sacroiliitis using Pearson correlation coefficients, and the mSASSS was examined in a number of different sub-groups.


Data was available for 319 AS patients who all fulfilled modified New York criteria. 79.9% were male, 80.5% were HLA-B27 positive, and 22.3% had juvenile onset AS (defined as symptom onset <= 16 years old). Mean (+/-SD) BASDAI was 4.6 (+/-2.6), mean BASFI was 3.8 (+/-2.8), and mean mSASSS was 18.4 (+/-22.6). Mean age was 40.2 (+/-13.1). Mean ESR was 13.5 (+/-14.5), and mean CRP was 11.9 (+/-15.5). There was a significant difference between the mSASSS scores for males versus female patients, for HLA-B27 positive versus negative patients, and for Adult onset versus Juvenile onset patients—see Table 1. There was a good correlation between the total mSASSS score and the grade of sacroiliitis (r=0.616, p<0.001). Specifically, male patients (r= 0.630, p<0.001), and adult-onset patients (r=0.653, p<0.001), had the strongest correlation between severity of spinal and sacroiliac disease.

Table 1. Mean (+/-SD) MSASSS for the different subgroups

 Mean mSASSS (+/-SD)
Total Cohort (N=319)18.4 (+/-22.6)
Male20.9 (+/-23.8)
Female8.2 (+/-12.6) p<0.001
Adult onset21.1 (+/-23.9)
Juvenile onset8.8 (+/-13.5) p<0.001
B27+ve18.5 (+/-22.7)
B27-ve11.5 (+/-16.2) p=0.007


Male AS patients who are HLA-B27 +ve, have the highest radiographic scores according to the mSASSS. Radiographic changes in the spine correlate well with the severity of sacroiliitis. Juvenile onset AS patients have less severe radiographic damage in comparison to adult onset AS. These features should assist in the identification of patients at higher risk of radiographic damage.

To cite this abstract, please use the following information:
O'Shea, Finbar (Barry) D., Haroon, Nigil, Riarh, Reena, Inman, R.D.; Associations with Radiographic Damage in Ankylosing Spondylitis in a Large Cohort [abstract]. Arthritis Rheum 2009;60 Suppl 10 :1792
DOI: 10.1002/art.26866

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