{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T06:40:30Z","timestamp":1787640030603,"version":"build-2736575974"},"reference-count":22,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T00:00:00Z","timestamp":1678665600000},"content-version":"unspecified","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Reuma Nederland"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2023,2,23]]},"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess construct validity of the CT Syndesmophyte Score (CTSS) for the measurement of structural spinal damage in patients with radiographic axial spondyloarthritis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Low-dose CT and conventional radiography (CR) were performed at baseline and 2\u2009years. CT was assessed with CTSS by two readers and CR with modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) by three readers. Two hypotheses were tested: (1) syndesmophytes scored with CTSS are also detected with mSASSS at baseline or 2\u2009years later; (2) CTSS is non-inferior to mSASSS in correlations with spinal mobility measures. Presence of a syndesmophyte was determined per reader per corner for all anterior cervical and lumbar corners on CT at baseline and CR at baseline and 2\u2009years. Correlations of CTSS and mSASSS with six spinal\/hip mobility measurements plus Bath Ankylosing Spondylitis Metrology Index (BASMI) were tested.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Data from 48 patients (85% male, 85% HLA-B27+, mean age 48 years) were available for hypothesis 1 and 41\/48 were available for hypothesis 2. At baseline, syndesmophytes were scored with CTSS in 348 (reader 1, 38%) and 327 (reader 2, 36%) corners out of 917. Of these, depending on reader pairs, 62%\u201379% were also seen on CR at baseline or after 2 years. CTSS correlated well (<jats:italic>r<jats:sub>s<\/jats:sub>\n                     <\/jats:italic>0.46\u20130.73), and with higher correlation coefficients than mSASSS (<jats:italic>r<jats:sub>s<\/jats:sub>\n                     <\/jats:italic>0.34\u20130.64), with all spinal mobility measures and BASMI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The good agreement between syndesmophytes detected by CTSS and mSASSS and the strong correlation of CTSS with spinal mobility support the construct validity of the CTSS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2022-002959","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T10:57:11Z","timestamp":1678705031000},"page":"e002959","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Good construct validity of the CT Syndesmophyte Score (CTSS) in patients with radiographic axial spondyloarthritis"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6706-3933","authenticated-orcid":false,"given":"Rosalinde","family":"Stal","sequence":"first","affiliation":[{"name":"Rheumatology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8899-9087","authenticated-orcid":false,"given":"Sofia","family":"Ramiro","sequence":"additional","affiliation":[{"name":"Rheumatology, Leiden University Medical Center, Leiden, The Netherlands"},{"name":"Rheumatology, Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9475-9362","authenticated-orcid":false,"given":"Xenofon","family":"Baraliakos","sequence":"additional","affiliation":[{"name":"Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9156-5095","authenticated-orcid":false,"given":"Juergen","family":"Braun","sequence":"additional","affiliation":[{"name":"Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique","family":"Reijnierse","sequence":"additional","affiliation":[{"name":"Radiology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosaline","family":"van den Berg","sequence":"additional","affiliation":[{"name":"Rheumatology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5781-158X","authenticated-orcid":false,"given":"D\u00e9sir\u00e9e","family":"van der Heijde","sequence":"additional","affiliation":[{"name":"Rheumatology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8448-7407","authenticated-orcid":false,"given":"Floris A","family":"van Gaalen","sequence":"additional","affiliation":[{"name":"Rheumatology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,3,13]]},"reference":[{"key":"2025090312543425000_9.1.e002959.1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-221035"},{"key":"2025090312543425000_9.1.e002959.2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.091793"},{"key":"2025090312543425000_9.1.e002959.3","first-page":"516","article-title":"Impact of functional impairment in ankylosing spondylitis: impairment, activity limitation, and participation restrictions","volume":"32","author":"Dagfinrud","year":"2005","journal-title":"J 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Five-year results from the DESIR cohort","volume":"57","author":"Ramiro","year":"2018","journal-title":"Rheumatology (Oxford)"},{"key":"2025090312543425000_9.1.e002959.11","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/key128"},{"key":"2025090312543425000_9.1.e002959.12","first-page":"S35","article-title":"Imaging of axial spondyloarthritis new aspects and differential diagnoses","volume":"36","author":"Braun","year":"2018","journal-title":"Clin Exp Rheumatol"},{"key":"2025090312543425000_9.1.e002959.13","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-212553"},{"key":"2025090312543425000_9.1.e002959.14","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211989"},{"key":"2025090312543425000_9.1.e002959.15","unstructured":"Beaton D , Maxwell L , Grosskleg S , et al . The OMERACT handbook version 2.1 [updated march 2021]. Omeract, 2021."},{"key":"2025090312543425000_9.1.e002959.16","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.1007\/s10067-015-3056-1","article-title":"Construct validity of clinical spinal mobility tests in ankylosing spondylitis: a systematic review and meta-analysis","volume":"35","author":"Castro","year":"2016","journal-title":"Clin Rheumatol"},{"key":"2025090312543425000_9.1.e002959.17","doi-asserted-by":"crossref","DOI":"10.1186\/ar4144","article-title":"Scoring radiographic progression in ankylosing spondylitis: should we use the modified stoke ankylosing spondylitis spine score (msasss) or the radiographic ankylosing spondylitis spinal score (rasss)?","volume":"15","author":"Ramiro","year":"2013","journal-title":"Arthritis Res Ther"},{"key":"2025090312543425000_9.1.e002959.18","doi-asserted-by":"crossref","first-page":"ii1","DOI":"10.1136\/ard.2008.104018","article-title":"The Assessment of Spondyloarthritis International Society (ASAS) Handbook: a guide to assess spondyloarthritis","volume":"68 Suppl 2","author":"Sieper","year":"2009","journal-title":"Ann Rheum Dis"},{"key":"2025090312543425000_9.1.e002959.19","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1093\/rheumatology\/kez026","article-title":"Measuring spinal mobility in early axial spondyloarthritis: does it matter?","volume":"58","author":"Marques","year":"2019","journal-title":"Rheumatology (Oxford)"},{"key":"2025090312543425000_9.1.e002959.20","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2021-001654","article-title":"Biological dmards and disease modification in axial spondyloarthritis: a review through the lens of causal inference","volume":"7","author":"Sepriano","year":"2021","journal-title":"RMD Open"},{"key":"2025090312543425000_9.1.e002959.21","first-page":"1","article-title":"Instrument selection for the ASAS core outcome set for axial spondyloarthritis","volume":"0","author":"Navarro-Comp\u00e1n","year":"2022","journal-title":"Ann Rheum Dis"},{"key":"2025090312543425000_9.1.e002959.22","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.msksp.2018.09.010","article-title":"Is the occiput-wall distance valid and reliable to determine the presence of thoracic hyperkyphosis?","volume":"38","author":"Wiyanad","year":"2018","journal-title":"Musculoskelet Sci Pract"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2022-002959","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T19:54:46Z","timestamp":1756929286000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2022-002959"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,3,13]]},"published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1136\/rmdopen-2022-002959"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2022-002959","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3]]}}}