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Health and functioning assessment
General health and functioning are of pivotal importance when assessing the impact of the disease on the patient. Recently, the ASAS Health Index (HI) has been developed to measure functioning and health in patients with SpA aiming to better describe the impact of disease in these patients15. The ASAS-HI is a new and linear composite measure based on an item pool which has been developed and based on the International Classification of Functioning core set for AS. This composite index forms a unidimensional scale providing a sum score representing a wide spectrum of different levels of functioning, and it contains 17 dichotomous questions addressing the following categories: pain, emotional functions, sleep, sexual functions, mobility, self-care, community life and employment.
In addition to the clinical picture, imaging (radiography and magnetic resonance imaging (MRI)) and laboratory data (HLA-B27 and C-reactive protein (CRP)) are important tools in daily clinical practice when assessing patients with SpA. MRI of the sacroiliac (SI) joints has become an important tool in the diagnosis and classification of SpA and its introduction as a diagnostic test has been a major advance in the field of SpA. MRI is particularly important for early diagnosis, especially because if its sensitivity to active inflammatory lesions early in the course of the disease, and often well before definite lesions on conventional radiographs are detectable16. This makes MRI the most sensitive imaging modality available for the detection of sacroiliitis. The role of HLA-B27 in the diagnosis, prognosis and management of SpA has been extensively investigated. HLA-B27 has been associated with an increased severity and persistence of SI-MRI- inflammation in (especially male) patients with IBP17. SI-MRI as well as HLA-B27 help to secure a diagnosis of axSpA and both have a
Magnetic Resonance Imaging and HLA-B27
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