There are no simple, objective measures which can be used to assess your AS
With conditions such as rheumatoid arthriitis (RA), rheumatologists rely a great deal on markers in the blood. These closely correlate to the symptoms people with RA experience. In AS, rheumatologists don't put too much emphasis on inflammatory markers in the blood as these often don't closely mirror symptoms. We know that in more than half of people with AS, inflammatory markers will be within the normal range, although these people may be experiencing a great deal of pain and stiffness.
So, your rheumatologist relies a great deal on you telling them how you feel. Try to be clear and accurate. The Talking AS tool can really help you describe your symptoms to your rheumatologist. If you try to do it monthly you will get a clear record of how your symptoms have been over time since your previous appointment.
There are a number of ways in which AS should be monitored by your rheumatology team
BASMI - A measure of spinal and hip movement. Scored out of 10. The higher your score, the more restricted you are due to your AS
BASDAI - A measure of disease activity. Scored out of 10. The higher your score, the more active your condition
BASFI - A measure of your functional activity (your ability to carry out everyday tasks). Scored out of 10. The higher your score, the more you are restricted
BAS-G - A measure of your coping ability. Scored out of 10. The higher your score, the greater the impact your AS is having on your ability to cope
ASQOL - A measure of quality of life. Scored at of 18. The higher the score, the worse your quality of life is because of your AS
Work instability - A measure to assess your ability to remain at work and be productive at work. Scored out of 20. Scores higher than 12 means youmay need support to continue working
ESR and CRP - A measure of inflammation in the body (via blood tests) which can indicate your disease is more active
Additional measures used to assess you for anti TNF therapy
Modified New York Criteria
To meet the New York Criteria you need to have:
- Low back pain and stiffness for more than 3 months that improves with exercise but is not relieved by rest
- Limitation of motion of the lumbar spine in the sagittal and frontal planes
- Limitation of chest expansion relative to normal values correlated by age and sex
Additionally, the radiological (x-ray) criteria is:
- Sacroiliitis grade>2 bilaterally or grade 3-4 unilaterally
Visual Analogue Spinal Pain Score
You are shown a line of 10cm in length with the words 'No pain' on the left hand end of the line and 'Pain as bad as it could possibly be' at the other end and you are be asked to put a mark on the line which represents your level of pain at the current time.
If you are being assessed for anti TNF therapy your score would need to be higher than 4 on two occasions 3 months apart to fit the eligibility criteria.
Last reviewed: May 2015