Spectrum of Radiographic Involvement in Axial Spondyloarthropathy Using the Modified Stokes Ankylosing Spondylitis Spine Score (MSASSS) and Modified Newyork Classification

Background: Ankylosing spondylitis is a chronic debilitating inflammatory disease of the spine and it can lead to significant disability and morbidity in patients which can affect their quality of life. Objectives: Modified Stokes Ankylosing Spondylitis Spinal Score (mSASSS) is a four-point (0-3) scoring system for lateral radiographs of the lumbar and cervical spine. The purpose of this study was to find out the mSASSS and the grade of sacroiliitis according to radiological criteria of MNYC in axial spondyloarthropathy patients. Methods: This descriptive cross-sectional study wasdone in the Rheumatologyoutpatient department at the Federal Government Polyclinic Hospital Islamabad from January 2023 till July 2023. The data was recorded onto a proforma after informed consent. Patients underwent x-rays of the cervical, lumbar spine for finding the mSASSS and the sacroiliac joints in standard positions for sacroiliitis based on the modified NewYork classification. BASDAI and ASDAS-CRP scores were assessed. Results: There were 40(86.9%) males and 6(13.1%) females. Of these, 27(58.7%) had a BASDAI score of ≥ 4 while 31 (67.3%) hadASDAS-CRP≥2.1 suggestive of active disease. The mean duration of disease was 6.51±4.43 years. The mean mSASSS of the patients was 9.69±17.99. Grade II and III sacroiliitis were the most frequent at 30.4% and 28.3% respectively as per the modified Newyork classification. The duration of disease, mSASSS(p=0.03) and the grade of sacroiliitis (p=0.015) showed a positive correlation. Conclusion: The modified stokes ankylosing spondylitis spine score and the grade of sacroiliitis suggest the severity of the disease. The mean MSASS score in our patients was 9.69±17.99, while grade II and III were the most prevalent grades of sacroiliitis based on the MNYC.The modified Stokes Ankylosing spondylitis spine score and the grade of sacroiliitis correlated with the duration of the disease. Grade of sacroiliitis also correlated with the mSASS score.