Skip to main content
SpringerLink
Log in

The relationship between enthesitis indices and disease activity parameters in patients with ankylosing spondylitis

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

In this study, patients with ankylosing spondylitis (AS) were assessed both by patient and physician using two enthesitis indices and the relationship between these indices and disease activity parameters was investigated. The study involved 100 AS patients. The patients were evaluated with 10-cm visual analog scale (VAS) for spinal pain (VAS-S), peripheral joint pain (VAS-P), global assessment of patient, and global assessment of doctor. In the laboratory evaluations, the erythrocyte sedimentation rates (ESR) and serum C-reactive protein levels of the patients were determined. Bath AS disease activity index (BASDAI), Bath AS functional index (BASFI), Bath AS metrology index, and Bath AS radiology index were calculated. The severity of enthesitis was evaluated according to Mander enthesitis index (MEI) and Maastricht ankylosing spondylitis enthesitis score applied by both the patient (MASES-P) him/herself and the physician (MASES-D). There was a correlation between BASDAI and BASFI as well as MEI, MASES-D, and MASES-P indices (r = 0.447, r = 0.342, r = 0.663, r = 0.530, r = 0.464, and r = 0.435, respectively). No correlation between the laboratory parameters and enthesitis indices were detected. In multiple linear regression analysis, BASFI, VAS-S, and female gender (41.3%) were the best predictors of MEI-D, whereas BASFI, VAS-S, female gender, and ESR (32.5%) were the best predictors for MASES-D and BASFI (18.9%) was the best predictor of MASES-P. The assessment of simple and easily applicable MASES score by a patient may be expected to help the physician in clinical practice. When the disease activity of the patients with AS are evaluated, both BASDAI, the clinical importance of which has been confirmed in numerous studies and which is recommended by ASAS, and BASFI, which is valued by patients, should be considered.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Auleley RG, Benbouazza K, Spoorenberg A et al (2002) Evaluation of the smallest detectable difference in outcome or process variables in ankylosing spondylitis. Arthritis Rheum 47(6):582–587

    Article  PubMed  Google Scholar 

  2. Bodur H, Ataman S, Akbulut L et al (2008) Characteristics and medical management of patients with rheumatoid arthritis and ankylosing spondylitis. Clin Rheumatol 27(9): 1119–1125 doi:10.1007/s10067-008-0877-1, Sep

    Article  Google Scholar 

  3. Khan MA (2000) Enthesitis: a broader definitaion. Ann Rheum Dis 59:998

    Google Scholar 

  4. McGonagle D, Khan MA, Marzo-Ortega H et al (1999) Enthesitis in spondyloarthropathy. Curr Opin Rheumatol 11:244–250

    Article  PubMed  CAS  Google Scholar 

  5. D’Agostino MA (2006) Enthesitis. Best Pract Res Clin Rheumatol 20(3):473–486

    Article  PubMed  Google Scholar 

  6. Kaya T, Bal S, Günaydın R (2007) Relationship between the severity of enthesitis and clinical and laboratory parameters in patients with ankylosing spondylitis. Rheumatol Int 27:323–327

    Article  PubMed  Google Scholar 

  7. Spoorenberg A, van Tubergen A, Landewe R et al (2005) Measuring disease activity in ankylosing spondylitis: patient and physician have different perspectives. Rheumatology 44:789–795

    Article  PubMed  CAS  Google Scholar 

  8. Özgöçmen S, Gödekmerdan A, Özkurt-Zengin F (2007) Acute-phase response, clinical measures and disease activity in ankylosing spondylitis. Jt Bone Spine 74:249–253

    Article  Google Scholar 

  9. Heuft-Dorenbosch L, Spoorenberg A, van Tubergen A et al (2003) Assessment of enthesitis in ankylosing spondylitis. Ann Rheum Dis 62:127–132

    Article  PubMed  CAS  Google Scholar 

  10. Mander M, Simpson JM, McLellan A et al (1987) Studies with an enthesis index as a method of clinical assessment in ankylosing spondylitis. Ann Rheum Dis 46:197–202

    Article  PubMed  CAS  Google Scholar 

  11. van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the new York criteria. Arthritis Rheum 27(4):361–368

    Article  PubMed  Google Scholar 

  12. Garret S, Jenksion T, Kennedy L et al (1994) A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis disease activity index. J Rheumatol 21:2286–2291

    Google Scholar 

  13. Calin A, Garret S, Whitelock HC et al (1994) A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol 21(12):2281–2285

    PubMed  CAS  Google Scholar 

  14. Jenkinson TR, Mallorie PA, Whitelock HC et al (1994) Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS Metrology Index. J Rheumatol 21(9):1694–1698

    PubMed  CAS  Google Scholar 

  15. Yanık B, Kurtaiş Gürsel Y, Kutlay Ş et al (2005) Adaptation of the Bath Ankylosing Spondylitis Functional Index to the Turkish population, its reliability and validity: functional assessment in AS. Clin Rheumatol 24:41–47

    Article  PubMed  Google Scholar 

  16. Akkoç Y, Karatepe AG, Akar S et al (2005) The Turkish versions of the Bath Ankylosing Spondylitis Disease Activity Index: reliability and validity. Rheumatol Int 25(4):280–284

    Article  PubMed  Google Scholar 

  17. Calin A, MacKay K, Santos H et al (1999) A new dimension to outcome: application of the Bath Ankylosing Spondylitis Radiology Index. J Rheumatol 26:988–992

    PubMed  CAS  Google Scholar 

  18. Kaya A, Özgöçmen S, Kamanlı A et al (2007) Evaluation of a quantitative scoring of enthesitis in ankylosing spondylitis. J Clin Rheumatol 13:303–306

    Article  PubMed  Google Scholar 

  19. Spoorenberg A, van der Heijde D, de Klerk E et al (1999) Relative value of erythrocyte sedimentation rate and C-reactive protein in assessment of disease activity in ankylosing spondylitis. J Rheumatol 26(4):980–984

    PubMed  CAS  Google Scholar 

  20. Spoorenberg A, van der Heijde D, Dougados M et al (2002) Reliability of self assessed joint counts in ankylosing spondylitis. Ann Rheum Dis 61:799–803

    Article  PubMed  CAS  Google Scholar 

Download references

Disclosures

None.

Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Ankara Numune Education and Research Hospital, Ceyhun Atıf Kansu Cad. 47. Sok 3/10, Çankaya, Ankara, Turkey

    Filiz Sivas, Bedriye Mermerci Başkan, Esra Erkol İnal, Lale Akbulut Aktekin, Kürşat Özoran & Hatice Bodur

  2. Department of Radiology, Ankara Numune Education and Research Hospital, Ankara, Turkey

    Nurdan Barça

Authors
  1. Filiz Sivas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bedriye Mermerci Başkan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Esra Erkol İnal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lale Akbulut Aktekin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nurdan Barça
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kürşat Özoran
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hatice Bodur
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Filiz Sivas.

Glossary

MEI

Mander enthesitis index

MASES-D

Maastricht Ankylosing spondylitis Enthesitis Score-Doctor

MASES-P

Maastricht Ankylosing spondylitis Enthesitis Score-Patient

BASDAI

Bath AS disease activity index

BASFI

Bath AS functional index

BASRI

Bath AS Radiology Index

BASMI

Bath AS metrology index

VAS-S

Visual analogue scale- Spinal

VAS-P

Visual analogue scale -Peripheral joint

ESR

Erythrocyte sedimentation rate

CRP

C-reactive protein

GAP

Global assessment of patient

GAD

Global assessment of doctor

LSP

Fifth lumbar spinous process

RFCCJ

Right first costochondral joints

LFCCJ

Left first costochondral joints

RSCCJ

Right seventh costochondral joints

LSCCJ

Left seventh costochondral joints

RPSIS

Right posterior superior iliac spine

LPSIS

Left posterior superior iliac spine

RASIS

Right anterior superior iliac spine

LASIS

Left anterior superior iliac spine

RIC

Right iliac crest

LIC

Left iliac crest

RAT

Right achilles tendon insertion

LAT

Left achilles tendon insertion

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sivas, F., Mermerci Başkan, B., Erkol İnal, E. et al. The relationship between enthesitis indices and disease activity parameters in patients with ankylosing spondylitis. Clin Rheumatol 28, 259–264 (2009). https://doi.org/10.1007/s10067-008-1027-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-008-1027-5

Keywords

Search

Navigation