title: Radiologic Changes in the Symphysis Pubis of Male Patients with Ankylosing Spondylitis.
abstract: OBJECTIVE
  We aimed to evaluate the involvement of the symphysis pubis in patients with ankylosing spondylitis (AS), and to assess the correlations between symphysis pubis changes and clinical findings.
  
  
  METHODS
  We retrospectively evaluated a total of 222 male patients with AS who underwent pelvic and cervical/lumbar spine radiography at the Hanyang University Hospital for Rheumatic Diseases from August 2004 to February 2014. Radiographs were examined by 2 experienced radiologists, and radiographic damage was scored as follows: 0 (no damage), 1 (subtle irregularity and/or subchondral sclerosis), 2 (erosion), 3 (partial ankylosis), and 4 (total ankylosis). We evaluated the patients' clinical characteristics and analyzed their correlations with radiographic symphysis pubis changes.
  
  
  RESULTS
  The mean patient age was 30.5 ± 8.3 years and mean disease duration was 7.1 ± 4.6 years; 105 patients (47.3%) exhibited radiologic damage in the symphysis pubis. Moreover, 75, 28, 0, and 2 patients had scores of 1, 2, 3, and 4, respectively. When comparing the normal (score 0) and abnormal (score 1-4) symphysis pubis groups, the latter had a longer symptom duration (10.1 ± 7.0 vs 7.6 ± 5.8 yrs, p = 0.004) and higher modified Stoke Ankylosing Spondylitis Spine Score (mSASSS; 18.6 ± 17.0 vs. 14.3 ± 13.4, p = 0.038). Moreover, a significant correlation was noted between the radiographic symphysis pubis damage score and mSASSS (r(2) = 0.147, p = 0.029).
  
  
  CONCLUSIONS
  Among male patients with AS, 47.3% exhibited symphysis pubis involvement. Moreover, a correlation was observed between the radiographic symphysis pubis and spine changes.
authors.affiliation: From the Division of Rheumatology, Department of Internal Medicine, Konkuk University College of Medicine, Chungju; Department of Radiology and Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea.B.S. Koo, MD, Division of Rheumatology, Department of Internal Medicine, Konkuk University College of Medicine; Y. Song, MD, Department of Radiology, Hanyang University Hospital for Rheumatic Diseases; K.B. Joo, MD, PhD, Department of Radiology, Hanyang University Hospital for Rheumatic Diseases; S. Lee, MD, PhD, Department of Radiology, Hanyang University Hospital for Rheumatic Diseases; T.H. Kim, MD, PhD, Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases.
authors.forename: Bon San
authors.initials: BS
authors.lastname: Koo
authors.affiliation: From the Division of Rheumatology, Department of Internal Medicine, Konkuk University College of Medicine, Chungju; Department of Radiology and Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea.B.S. Koo, MD, Division of Rheumatology, Department of Internal Medicine, Konkuk University College of Medicine; Y. Song, MD, Department of Radiology, Hanyang University Hospital for Rheumatic Diseases; K.B. Joo, MD, PhD, Department of Radiology, Hanyang University Hospital for Rheumatic Diseases; S. Lee, MD, PhD, Department of Radiology, Hanyang University Hospital for Rheumatic Diseases; T.H. Kim, MD, PhD, Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases.
authors.forename: Yoonah
authors.initials: Y
authors.lastname: Song
authors.affiliation: From the Division of Rheumatology, Department of Internal Medicine, Konkuk University College of Medicine, Chungju; Department of Radiology and Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea.B.S. Koo, MD, Division of Rheumatology, Department of Internal Medicine, Konkuk University College of Medicine; Y. Song, MD, Department of Radiology, Hanyang University Hospital for Rheumatic Diseases; K.B. Joo, MD, PhD, Department of Radiology, Hanyang University Hospital for Rheumatic Diseases; S. Lee, MD, PhD, Department of Radiology, Hanyang University Hospital for Rheumatic Diseases; T.H. Kim, MD, PhD, Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases.
authors.forename: Kyung Bin
authors.initials: KB
authors.lastname: Joo
authors.affiliation: From the Division of Rheumatology, Department of Internal Medicine, Konkuk University College of Medicine, Chungju; Department of Radiology and Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea.B.S. Koo, MD, Division of Rheumatology, Department of Internal Medicine, Konkuk University College of Medicine; Y. Song, MD, Department of Radiology, Hanyang University Hospital for Rheumatic Diseases; K.B. Joo, MD, PhD, Department of Radiology, Hanyang University Hospital for Rheumatic Diseases; S. Lee, MD, PhD, Department of Radiology, Hanyang University Hospital for Rheumatic Diseases; T.H. Kim, MD, PhD, Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases. radsh@hanyang.ac.kr thkim@hanyang.ac.kr.
authors.forename: Seunghun
authors.initials: S
authors.lastname: Lee
authors.affiliation: From the Division of Rheumatology, Department of Internal Medicine, Konkuk University College of Medicine, Chungju; Department of Radiology and Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea.B.S. Koo, MD, Division of Rheumatology, Department of Internal Medicine, Konkuk University College of Medicine; Y. Song, MD, Department of Radiology, Hanyang University Hospital for Rheumatic Diseases; K.B. Joo, MD, PhD, Department of Radiology, Hanyang University Hospital for Rheumatic Diseases; S. Lee, MD, PhD, Department of Radiology, Hanyang University Hospital for Rheumatic Diseases; T.H. Kim, MD, PhD, Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases. radsh@hanyang.ac.kr thkim@hanyang.ac.kr.
authors.forename: Tae-Hwan
authors.initials: TH
authors.lastname: Kim
mesh_terms: D000328:Adult; D018450:Disease Progression; D006801:Humans; D008297:Male; D011630:Pubic Bone / Q000000981:diagnostic imaging*; D011631:Pubic Symphysis / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: ANKYLOSING SPONDYLITIS; MODIFIED STOKE ANKYLOSING SPONDYLITIS SPINE SCORE; SYMPHYSIS PUBIS