Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.

Disease Activity Assessment by ASDAS Doesn't Predict Sacroiliac Inflammation with MRI in Axial SpA.

Aydin2,  Sibel Z., Bennett1,  Alex, Emery2,  Paul, McGonagle2,  Dennis, Marzo-Ortega2,  Helena

Defence Medical Rehabilitation Centre, Headley Court, Epsom, Surrey
Section of Musculoskeletal Diseases, The Leeds Institute of Molecular Medicine. University of Leeds, UK


The ASDAS (Ankylosing spondylitis disease activity score) is a newly developed composite index to measure disease activity in AS. It incorporates items of back pain, morning stiffness, patient global assessment of disease activity, pain/swelling of the peripheral joints and the CRP using a weighted formula. In the present study we aimed to test the construct validity of ASDAS comparing it with active inflammation of the sacroiliac joints (SIJs) as shown by MRI.


Twenty-three patients (n=23) with axial SpA according to the ASAS criteria were included. All patients were questioned for the parameters included in ASDAS and had an MRI scan of the SIJs. ASDAS values were categorized according to the different cut-off levels recently presented at OMERACT 10 and compared to the MRI findings according to the guidance of ASAS proposals. Further scoring to identify patients with severe MRI sacroiliitis (grade 3 according to the Leeds MRI SIJ Scoring System) and total MRI scores (sum of scores at all quadrants with a maximum score of 24) were also available.


All patients had active disease according to ASDAS (scores >1.3).

Moderate disease was found in 13%, 39 % had active and 48 % had very active disease. No relationship was found between the different states of disease activity according to ASDAS and MRI findings, including severity of the MRI. Similarly, ASDAS levels were found comparable in groups with/without sacroiliitis by MRI (3.5 ±1.1 vs 3.1±0.9, p=0.5, respectively) and severe sacroiliitis by MRI (3.5 ±1.8 vs 3.4±0.9, p=0.8, respectively). MRI scores were also independent from ASDAS categories.


Besides the clinical benefits of ASDAS, there does not appear to be a relationship between ASDAS and the presence of bone marrow oedema on MRI at the SIJ of axial SpA patients.

Table 1. Distribution of ASDAS according MRI findings

Disease activity according to ASDASASDAS cut off levelsPositive MRI (n)Severe sacriolitis by MRI (n)MRI scores median (range)
  + n = 18- n = 5+ n = 4- n = 19 
inactive disease<1.30000NA
moderate activity1.3–2.121125 (0–16)
high activity2.1–3.572181 (0–18)
very high activity>3.592292 (0–12)
  p = NSp = NSp = NS

To cite this abstract, please use the following information:
Aydin, Sibel Z., Bennett, Alex, Emery, Paul, McGonagle, Dennis, Marzo-Ortega, Helena; Disease Activity Assessment by ASDAS Doesn't Predict Sacroiliac Inflammation with MRI in Axial SpA. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :524
DOI: 10.1002/art.28293

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