Can grading method of BASRI-hip based on X-ray examination better identify hip involvement?

Dear Editor,

We have read the article entitled “Risk factors for radiological hip involvement in patients with ankylosing spondylitis” that analyzes the risk factors of hip involvement in patients with ankylosing spondylitis (AS). In this study, the authors analyzed the clinical characteristics of patients with hip involvement due to AS evaluated by X-ray. From this analysis, it is found that juvenile onset, lower body mass index, and bone mass below the expected range for age were independently associated with radiological hip joint involvement in patients with AS and suggested that the use of nonsteroidal anti-inflammatory drugs can improve the prognosis¹.

However, from our point of view, some information need to be clear in this study.

First, although the grading method of BASRI-hip based on X-ray examination has good reliability, it is not ideal in describing the sensitivity of severe hip involvement²,³. We still hope to read the data of morphological and histological changes of hip joint for quantitative evaluation.

Second, in the study design, the inclusion criteria should be included in the latest diagnostic criteria⁴. It is particularly important to identify patients with negative radiological examination and to exclude all hip joint involvements not due to AS, such as hip joint injury caused by trauma, congenital disease, or systemic disease.

Third, the clinical data of this study need to include the treatment factors affecting the hip involvement in the follow-up, such as whether the patient has undergone surgery, physical therapy, or rehabilitation treatment and the work, living environment, and lifestyle of patients⁵.

• Funding: none.

REFERENCES

• ¹
  Chen S, Deng L. Risk factors for radiological hip involvement in patients with ankylosing spondylitis. Rev Assoc Med Bras (1992). 2021;67(9):1293-8. https://doi.org/10.1590/1806-9282.20210585
  » https://doi.org/10.1590/1806-9282.20210585
• ²
  Singh G, Lawrence A, Agarwal V, Misra R, Aggarwal A. Higher prevalence of extra-articular manifestations in ankylosing spondylitis with peripheral arthritis. J Clin Rheumatol. 2008;14(5):264-6. https://doi.org/10.1097/RHU.0b013e31817b8789
  » https://doi.org/10.1097/RHU.0b013e31817b8789
• ³
  Cruyssen BV, Vastesaeger N, Collantes-Estévez E. Hip disease in ankylosing spondylitis. Curr Opin Rheumatol. 2013;25(4):448-54. https://doi.org/10.1097/BOR.0b013e3283620e04
  » https://doi.org/10.1097/BOR.0b013e3283620e04
• ⁴
  van der Heijde D, Ramiro S, Landewé R, Baraliakos X, Van den Bosch F, Sepriano A, et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis. 2017;76(6):978-91. https://doi.org/10.1136/annrheumdis-2016-210770
  » https://doi.org/10.1136/annrheumdis-2016-210770
• ⁵
  Skare TL, Leite N, Bortoluzzo AB, Gonçalves CR, Silva JA, Ximenes AC, et al. Effect of age at disease onset in the clinical profile of spondyloarthritis: a study of 1424 Brazilian patients. Clin Exp Rheumatol. 2012;30(3):351-7. PMID: 22510473

Publication Dates

• Publication in this collection
  08 Aug 2022
• Date of issue
  July 2022

History

• Received
  02 Mar 2022
• Accepted
  20 Mar 2022