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MRI Spine Score for Ankylosing Spondylitis (AS)

Purpose: To evaluate a patient's ankylosing spondylitis based on changes to the vertebral bodies as seen on an MRI scan using the Berlin Spine Score.

Description

Braun et al developed a score for grading the severity of ankylosing spondylitis affecting the vertebral column. This can be used for initial assessment and for monitoring the effectiveness of therapy. The authors are University Hospital Benjamin Franklin in Berlin, multiple universities in Germany and University Hospital Maastricht.


Parameters:

(1) activity score

(2) chronicity score

 

Vertebral units (VU) were defined as the zone between the middle of one vertebral body and the middle of the vertebral body immediately below, encompassing the intervertebral disc).

 

Vertebral units assessed:

(1) C2-C3

(2) C3-C4

(3) C4-C5

(4) C5-C6

(5) C6-C7

(6) C7-T1

(7) T1-T2

(8) T2-T3

(9) T3-T4

(10) T4-T5

(11) T5-T6

(12) T6-T7

(13) T7-T8

(14) T8-T9

(15) T9-T10

(16) T10-T11

(17) T11-T12

(18) T12-L1

(19) L1- L2

(20) L2-L3

(21) L3-L4

(22) L4-L5

(23) L5-S1

 

Parameter

Finding

Points

activity

no lesions

0

 

minor bone marrow edema and/or enhancement <= 25%

1

 

moderate bone marrow edema and/or enhancement 26-50%

2

 

major bone marrow edema and/or enhancement 51-100%

3

 

minor erosions (<= 25%) with marrow edema and/or enhancement

4

 

moderate erosions (26-50%) with bone marrow edema and/or enhancement

5

 

major erosion (51-100%) with bone marrow edema and/or enhancement

6

chronicity

no lesions

0

 

minor sclerosis

1

 

sclerosis, vertebral squaring, possible syndesmophyte

2

 

1 or 2 syndesmophyte and/or small erosions

3

 

3 or more syndesmophyte and.or spondylodiscitis and/or severe erosions

4

 

vertebral bridging

5

 

vertebral fusion

6

 

score for each vertebral unit =

= (points for activity score) + (points for chronicity score)

 

total score for activity for the spine =

= SUM(activity score for each vertebral unit)

 

total score for chronicity for the spine =

= SUM(chronicity score for each vertebral unit)

 

Interpretation:

• minimum activity or chronicity score: 0

• maximum score for activity or chronicity: 138

• The higher the scores the more severe the ankylosing spondylitis.


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Specialty

Objective

ICD-10