{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:38:30Z","timestamp":1787017110487,"version":"build-2736575974"},"reference-count":23,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T00:00:00Z","timestamp":1708646400000},"content-version":"unspecified","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2024,2,5]]},"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The assessment of the cervical spine (CS) in axial spondyloarthritis (axSpA) and its radiographic characteristics, including the zygapophyseal joints (ZJ), may be helpful for an accurate diagnosis, establishing a prognosis and enhancing treatment decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe the prevalence and characteristics of CS involvement in patients with axSpA and perform a comparison between groups according to cervical radiographic damage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who fulfilled the Assessment of SpondyloArthritis International Society classification criteria were included from January 2011 to January 2021. Sociodemographic, clinical, radiographic and treatment variables were gathered. Patients were categorised into \u2018CS group\u2019 (Bath Ankylosing Spondylitis Radiology Index \u22652\u2009or De Vlam score \u22653 for ZJ) and \u2018no CS group\u2019 as controls. ZJ fusion and interobserver reliability in ZJ scoring were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 340 patients were included, 244 (71.7%) men, with mean age 57\u00b115 years. CS involvement was observed in 181 (53.2%) patients. Patients in the CS group, as compared with no CS group, were predominantly men, older, had a higher body mass index, higher prevalence of smoking, showed higher disease activity, worse functionality and mobility, as well as more structural damage. Sixty-nine patients with CS involvement had ZJ fusion at some level. These patients showed worse mobility and more radiographic damage. Overall, ZJ involvement was observed in 99 patients (29.1%), 20 of whom did not present with vertebral body involvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Radiographic evaluation of CS is relevant in patients with axSpA and should be assessed routinely. Evaluation of the ZJ is particularly significant, as it is related to higher disease activity and worse function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2023-003990","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T11:45:39Z","timestamp":1708688739000},"page":"e003990","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Exploring radiographic patterns of the cervical spine, including zygapophyseal joints, in axial spondyloarthritis"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3373-7503","authenticated-orcid":false,"given":"Laura","family":"Berbel-Arcob\u00e9","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9119-5330","authenticated-orcid":false,"given":"Diego","family":"Benavent","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xabier","family":"Michelena","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Vall d'Hebron University Hospital, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Antonio","family":"Narv\u00e1ez","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan Miquel","family":"Nolla","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Juanola","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,2,23]]},"reference":[{"key":"2025090313212474000_10.1.e003990.1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2004.029728"},{"key":"2025090313212474000_10.1.e003990.2","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1038\/s41584-023-00986-6","article-title":"The bone marrow side of axial Spondyloarthritis","volume":"19","author":"Mauro","year":"2023","journal-title":"Nat Rev Rheumatol"},{"key":"2025090313212474000_10.1.e003990.3","first-page":"1236","article-title":"The natural history of Ankylosing Spondylitis as defined by radiological progression","volume":"29","author":"Brophy","year":"2002","journal-title":"J Rheumatol"},{"key":"2025090313212474000_10.1.e003990.4","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes052"},{"key":"2025090313212474000_10.1.e003990.5","doi-asserted-by":"publisher","DOI":"10.1136\/ard.57.3.135"},{"key":"2025090313212474000_10.1.e003990.6","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1016\/j.semarthrit.2016.11.003","article-title":"Radiographic damage and progression of the Cervical spine in Ankylosing Spondylitis patients treated with TNF-\u0391 inhibitors: facet joints vs. vertebral bodies","volume":"46","author":"Maas","year":"2017","journal-title":"Semin Arthritis Rheum"},{"key":"2025090313212474000_10.1.e003990.7","doi-asserted-by":"crossref","DOI":"10.1186\/s41927-023-00334-x","article-title":"Radiographic involvement of Cervical facet joints in Ankylosing Spondylitis: a longitudinal analysis in correlation with vertebral body lesions","volume":"7","author":"Lee","year":"2023","journal-title":"BMC Rheumatol"},{"key":"2025090313212474000_10.1.e003990.8","first-page":"1738","article-title":"Involvement of the Zygapophyseal joint in Ankylosing Spondylitis: relation to the bridging Syndesmophyte","volume":"26","author":"de Vlam","year":"1999","journal-title":"J Rheumatol"},{"key":"2025090313212474000_10.1.e003990.9","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa155"},{"key":"2025090313212474000_10.1.e003990.10","doi-asserted-by":"crossref","DOI":"10.1186\/s13075-017-1285-1","article-title":"Incorporating assessment of the Cervical facet joints in the modified Stoke Ankylosing Spondylitis spine score is of additional value in the evaluation of spinal radiographic outcome in Ankylosing Spondylitis","volume":"19","author":"Maas","year":"2017","journal-title":"Arthritis Res Ther"},{"key":"2025090313212474000_10.1.e003990.11","doi-asserted-by":"crossref","DOI":"10.1016\/j.semarthrit.2022.151991","article-title":"Facet joint disease in patients with axial Spondyloarthritis: A retrospective computed tomography study","volume":"55","author":"Slobodin","year":"2022","journal-title":"Semin Arthritis Rheum"},{"key":"2025090313212474000_10.1.e003990.12","first-page":"1732","article-title":"The Zygapophyseal joint determines morphology of the Enthesophyte","volume":"27","author":"de Vlam","year":"2000","journal-title":"J Rheumatol"},{"key":"2025090313212474000_10.1.e003990.13","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1002\/acr.21648","article-title":"Impact of uveitis on the phenotype of patients with recent inflammatory back pain: data from a prospective multicenter French cohort","volume":"64","author":"Wendling","year":"2012","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2025090313212474000_10.1.e003990.14","doi-asserted-by":"publisher","DOI":"10.1007\/s100670170041"},{"key":"2025090313212474000_10.1.e003990.15","doi-asserted-by":"publisher","DOI":"10.1097\/00124743-200202000-00006"},{"key":"2025090313212474000_10.1.e003990.16","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/33.3.255"},{"key":"2025090313212474000_10.1.e003990.17","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209853"},{"key":"2025090313212474000_10.1.e003990.18","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.rdc.2020.01.009","article-title":"Axial Psoriatic arthritis: A distinct clinical entity in search of a definition","volume":"46","author":"Michelena","year":"2020","journal-title":"Rheum Dis Clin North Am"},{"key":"2025090313212474000_10.1.e003990.19","doi-asserted-by":"publisher","DOI":"10.1136\/ard.51.1.73"},{"key":"2025090313212474000_10.1.e003990.20","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.080491"},{"key":"2025090313212474000_10.1.e003990.21","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.161462"},{"key":"2025090313212474000_10.1.e003990.22","first-page":"977","article-title":"The radiological assessment of axial involvement in Psoriatic arthritis: a validation study of the BASRI total and the modified SASSS scoring methods","volume":"27","author":"Lubrano","year":"2009","journal-title":"Clin Exp Rheumatol"},{"key":"2025090313212474000_10.1.e003990.23","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1038\/s41584-020-00552-4","article-title":"Axial Spondyloarthritis: concept, construct, classification and implications for therapy","volume":"17","author":"Robinson","year":"2021","journal-title":"Nat Rev Rheumatol"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2023-003990","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T20:21:41Z","timestamp":1756930901000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2023-003990"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,2,23]]},"published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1136\/rmdopen-2023-003990"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2023-003990","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2]]}}}