Use of the Oswestry Disability Index in ankylosing spondylitis
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Abstract:
The Oswestry Disability Index is considered the gold standard in the evaluation of disability in patients with chronic mechanical back pain. The aim of this study was to assess the applicability of Oswestry Disability Index in patients with ankylosing spondylitis and its relationship with disease assessment parameters for ankylosing spondylitis.A total of 100 patients diagnosed with ankylosing spondylitis were included in the study group. The control group consisted of 50 individuals with nonspecific low back pain. The Oswestry Disability Index and Bath Ankylosing Spondylitis Disease Activity Index were applied to both groups. In addition, the Visual Analog Scale, the Ankylosing Spondylitis Disease Activity Score C-Reactive Protein, the Ankylosing Spondylitis Disease Activity Score-the Erythrocyte Sedimentation Rate, the Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, and the Ankylosing Spondylitis Quality of Life scales were applied in the study group. the Erythrocyte Sedimentation Rate, C-Reactive Protein levels, and HLA-B27 analysis were noted as laboratory markers in ankylosing spondylitis patients.The scores of Oswestry Disability Index had a significant correlation with scores of Bath Ankylosing Spondylitis Disease Activity Index in ankylosing spondylitis patients (r=0.543) and in the control group (r=0.401). There was a significant correlation between the scores of Oswestry Disability Index and the Bath Ankylosing Spondylitis Functional Index (r=0.544), Bath Ankylosing Spondylitis Metrology Index (r=0.317), the Ankylosing Spondylitis Quality of Life (r=0.723), the Ankylosing Spondylitis Disease Activity Score-the Erythrocyte Sedimentation Rate (r=0.501), the Ankylosing Spondylitis Disease Activity Score C-Reactive Protein (r=0.530), Visual Analog Scale-Rest (r=0.476), and Visual Analog Scale-Activity (r=0.441) values in patients with ankylosing spondylitis.Evaluation of Oswestry Disability Index in conjunction with Bath Ankylosing Spondylitis Disease Activity Index may warn the physician to interpret high Bath Ankylosing Spondylitis Disease Activity Index scores in the context of mechanical pain. Therefore, the use of Oswestry Disability Index in patients with ankylosing spondylitis will be beneficial.Keywords:
Erythrocyte sedimentation rate
Oswestry Disability Index
Spondylitis
Unusual destructive lesions of the cervical and lumbar vertebrae are described in two patients with ankylosing spondylitis. Biopsy of a lesion from one of the patients showed it to be inflammatory in nature. Possible mechanisms for vertebral centrum involvement in ankylosing spondylitis, centering on the role of enthesopathies are discussed.
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Objectives: This study aims to evaluate the associations between neutrophil-lymphocyte ratio (NLR), mean platelet volume, and platelet lymphocyte ratio (PLR) with disease activity in ankylosing spondylitis. Patients and methods: The study included 103 patients (63 males, 40 females; mean age 40.7±12.0 years; range 20 to 70 years) with ankylosing spondylitis and 70 healthy controls (43 males, 27 females; mean age 42.7±15.3 years; range 18 to 66 years). All participants' age, sex, erythrocyte sedimentation rate, C-reactive protein and mean platelet volume levels, total white blood cell, neutrophil, lymphocyte, and platelet counts were recorded while patients' Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index and Bath Ankylosing Spondylitis Metrology Index scores, medication types, duration of disease and medication use were recorded. Patients were divided into three groups: healthy controls (group 1), patients having BASDAI scores <4 with mild disease activity (group 2, n=73), and patients having BASDAI scores ≥4 with moderate-severe disease activity (group 3, n=30). NLR and PLR values were calculated. Results: Counts of neutrophil, NLR, C-reactive protein levels and PLR were significantly higher in group 3 compared to groups 1 and 2 (p<0.05). BASDAI scores were correlated weakly with neutrophil counts, NLR and PLR, and correlated moderately with C-reactive protein and erythrocyte sedimentation rate (p<0.05). Conclusion: Our study results indicate that, in ankylosing spondylitis, mean platelet volume is not associated with disease activity, whereas NLR and PLR may reflect disease activity.
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Mean platelet volume
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Ankylosing spondylitis is not an uncommon disease worldwide, yet is relatively rare in Bahrain. There is a typical pattern of joint involvement in cases of ankylosing spondylitis, but the presentation of discitis is rare. We present a case of a patient presenting with backache and was diagnosed to have discitis. The diagnosis of ankylosing spondylitis was made only after he was found to be Human Leukocyte Antigen-B27 positive. This is the first case report of ankylosing spondylitis presenting as discitis in Bahrain.
Discitis
Spondylitis
Presentation (obstetrics)
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Oswestry Disability Index
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Expression of fibronectin and MMP-3 and its significance in the patients with ankylosing spondylitis
Objective: To observe the expression and significance of fibronectin and metalloproteinase-3 (MMP-3) in patients with ankylosing spondylitis (AS). Methods: A total of 30 AS patients in our hospital and 30 healthy volunteers were selected in our study. Fibronectin and MMP-3 were measured and compared between these two groups. The AS group received sulfasalazine 2 g daily for 3 months. Bath ankylosing spondylitis disease activity index, bath ankylosing spondylitis functional index, bath ankylosing spondylitis metrology index, erythrocyte sedimentation rate and C-reactive protein were compared before and after treatment. Pearson's linear-correlation analysis was used to determine relationships between parameters. Results: Totally 28 patients in the AS group completed the study. Fibronectin and MMP-3 in peripheral blood of AS patients were evidently higher than that in the normal control group (P<0.05). After treated by sulfasalazine, the level of expressing Fibronectin and MMP-3 significantly decreased compared with baseline values (P<0.05). Pearson's linear-correlation analysis showed that serum fibronectin and MMP-3 level had a positive correlation with bath ankylosing spondylitis disease activity index global assessment, spine pain, night pain, general pain, erythrocyte sedimentation rate and C-reactive protein (P<0.05). Conclusions: The expression of fibronectin and MMP-3 in AS patients were significantly higher than that in the normal control group, and they all decreased significantly after treatment. It indicated that both fibronectin and MMP-3 were correlated closely with the onset of AS.
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Sulfasalazine
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Serum C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured on 469 occasions in 149 patients with ankylosing spondylitis who had also been investigated for faecal carriage of klebsiella/enterobacter species on the same occasions. Raised values of CRP and ESR correlated with each other (P less than 0.001) as well as with clinically assessed active disease episodes (P less than 0.001). Patients with positive cultures for klebsiella were found to have higher mean values for CRP and ESR than those with negative cultures (P less than 0.025). CRP appears to be a useful marker of disease activity in ankylosing spondylitis.
Erythrocyte sedimentation rate
Klebsiella
Spondylitis
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Reactive arthritis
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IS ankylosing spondylitis a distinct entity1 2 3 4 5 6 7 8 9 10 or a variant of rheumatoid arthritis?11 12 13 14 15 16 17 McEwen et al.18 regard spondylitis restricted to sacroiliac joints and spine, with or without hip and shoulder involvement, as a distinct disorder; spondylitis with peripheral joint disease is considered a variant of rheumatoid arthritis. There seem to be sufficient differences between the two conditions clinically, radiologically, serologically and therapeutically to justify Graham's7 conclusion that ". . . The enforced marriage of rheumatoid arthritis and ankylosing spondylitis should be annulled on the basis of incompatibility."A striking difference between ankylosing spondylitis and rheumatoid arthritis cited by proponents of the . . .
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The aim of this study was to assess the relation of systemic immune inflammation index, systemic inflammation response index, and systemic inflammation aggregate index with disease activity, functional status, and general health status in ankylosing spondylitis.Patients with ankylosing spondylitis and healthy volunteers were included in this cross-sectional study. Demographic data; disease activity measurements such as the Bath Ankylosing Spondylitis Disease Activity Index, the Ankylosing Spondylitis Disease Activity Score with C-reactive protein, and the Ankylosing Spondylitis Disease Activity Score with erythrocyte sedimentation rate; functional status such as the Bath Ankylosing Spondylitis Functional Index; and general health status such as the Assessment of Spondyloarthritis International Society Health Index of the patients were recorded. C-reactive protein, erythrocyte sedimentation rate, platelet to lymphocyte ratio, neutrophil to lymphocyte ratio, monocyte to lymphocyte ratio, systemic immune inflammation index, systemic inflammation response index, and systemic inflammation aggregate index values were recorded. Patients were grouped as active and remission according to the Bath Ankylosing Spondylitis Disease Activity Index score and as inactive-low and high-very high disease activity according to the Ankylosing Spondylitis Disease Activity Score. The correlation of laboratory parameters with disease-related parameters was tested.The indexes were significantly higher in patients compared to controls (p<0.001, for platelet to lymphocyte ratio p=0.03). No significant differences existed in any blood cell-derived indexes among patient groups categorized by disease activity (p<0.05 for all). Systemic immune inflammation index was weakly correlated with Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ρ=0.197 and p=0.049) and Ankylosing Spondylitis Disease Activity Score-erythrocyte sedimentation rate (ρ=0.201 and p=0.045). Systemic immune inflammation index was not correlated with Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, and Assessment of Spondyloarthritis International Society Health Index. No correlation was found between other indexes and disease-related variables. Platelet to lymphocyte ratio, systemic immune inflammation index, systemic inflammation response index, and systemic inflammation aggregate index showed a weak positive correlation with C-reactive protein and erythrocyte sedimentation rate (ρ=0.200-0.381).Systemic immune inflammation index, systemic inflammation response index, and systemic inflammation aggregate index can be used to indicate systemic inflammatory burden in ankylosing spondylitis patients. However, these indexes are not effective in indicating patients' disease activity, general health status, and functional status.
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Ananalysis oftheageatfirst presentation was undertaken in patients withankylosing spondylitis andmechanical backpainseenat theLondonHospital department ofrheumatology between 1952and1983. Therewasa significant positive correlation withthe calendar yearofpresentation inthepatients withankylosing spondylitis buta negative correlation inthosewithmechanical back pain. An increasing ageatpresentation in ankylosing spondylitis islikely tobeduetoan increasing ageatdisease onset-all anticipated biases wouldactintheopposite direction. Thisobservation ina prospective study supports thefindings ofother studies using different epidemiological techniques.
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