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Do We Really Need to Evaluate Entire Cervical Spines for Squaring Score in Modified Stoke Ankylosing Spondylitis Spinal Score?
TAE-JONG KIM, HEE-SUN KIM, KYUNG-BIN JOO, SUNGJUN KIM, and TAE-HWAN KIM
ABSTRACT. Methods. The study group comprised 125 healthy subjects and 135 patients with AS. Two experienced radiologists assessed the presence or absence of squaring in the individual cervical vertebrae twice independently. The frequencies of squaring of each vertebral site were obtained, and the differences between the control and AS groups were statistically analyzed. Results. Kappa intra- and interobserver reliability coefficients were 0.76 and 0.61, respectively. The frequency of spinal squaring for each vertebra in the control group was as follows: the 2nd (lower border 100%), 3rd (upper border 85.2%–91.0%, lower border 91.0%–93.4%), 4th (upper border 44.3%–49.2%, lower border 57.4%–63.1%), 5th (upper border 5.0%–6.6%, lower border 8.4%–15%), 6th (upper border 2.7%–7.3%, lower border 4.7%–8.6%), 7th cervical vertebra (upper border 39.7%–45.6%, lower border 51.5%–54.1%), and the 1st thoracic vertebra (upper border 56.0%–62.5%). Although there were statistically significant differences at 4th, 5th, 6th, and upper border of 7th cervical vertebra, a high proportion of normal 4th and 7th cervical vertebra were scored as squared. Conclusion. Only the 5th and 6th cervical spines are useful for scoring squaring of cervical spine in the mSASSS. (First Release Jan 15 2008; J Rheumatol 2008;35:477-9) Key Indexing Terms:
ANKYLOSING SPONDYLITIS
From the Department of Rheumatology and Department of Radiology, The Hospital for Rheumatic Diseases, Hanyang University College of Medicine; and the Department of Radiology, Hanyang University GURI Hospital, Hanyang University College of Medicine, Seoul, Korea. T-J. Kim, MD, Instructor of Medicine; H-S. Kim, MD, Clinical Fellow; T-H. Kim, MD, PhD, Associate Professor, Department of Rheumatology, The Hospital for Rheumatic Diseases, Hanyang University College of Medicine; K-B. Joo, MD, PhD, Professor, Department of Radiology, The Hospital for Rheumatic Diseases, Hanyang University College of Medicine; S. Kim, MD, PhD, Assistant Professor, Department of Radiology, Hanyang University GURI Hospital, Hanyang University College of Medicine. Address reprint requests to Dr. T-H. Kim, Department of Rheumatology, The Hospital for Rheumatic Diseases, Hanyang University College of Medicine, 17 Haengdang-Dong, Sungdong-Gu, Seoul 133-792, Korea. E-mail: thkim@hanyang.ac.kr Accepted for publication October 22, 2007. |
