Jenkinson et al defined the Bath Ankylosing Spondylitis Metrology Index (BASMI) to describe spinal mobility in a patient with ankylosing spondylitis. The authors are from the Royal National Hospital for Rheumatic Diseases in Bath, England.
Patient examination (page 1695):
(1) The examination is performed in mid-morning (after resolution of morning stiffness).
(2) Tragus to wall distance: The patient stands with heels and buttocks touching the wall with knees straight, shoulders back and chin in.
(3) Lumbar flexion: Based on the Macrae and Wright modification of the Schober Index, with the patient bending forward with the knees straight (see below).
(4) Cervical rotation is measured to the left and to the right side in degrees while the patient is supine.
(5) Lumbar side flexion: The patient performs full lateral flexion to the left or right without flexing forward or bending of the knees, with the middle finger moving along a long rule. The distance along the ruler traversed from standing upright to maximum lateral flexion is recorded.
(6) Intermalleolar distance: The patient is supine with knees straight and feet pointing straight up. The legs are separated as far as possible and the distance is measured between the medial malleoli.
Parameters:
(1) distance from tragus (external ear) to wall in centimeters
(2) lumbar forward flexion in centimeters (mean of left and right distances)
(3) cervical rotation in degrees (mean of rotation to left and right)
(4) lumbar side flexion in centimeters
(5) intermalleolar distance in centimeters
|
Parameter
|
Finding
|
Points
|
|
tragus to wall distance
|
< 15 cm
|
0
|
|
|
15 - 30 cm
|
1
|
|
|
> 30 cm
|
2
|
|
lumbar forward flexion (mean)
|
> 4 cm
|
0
|
|
|
2 - 4 cm
|
1
|
|
|
< 2 cm
|
2
|
|
cervical rotation (mean)
|
> 70 degrees
|
0
|
|
|
20- 70 degrees
|
1
|
|
|
< 20 degrees
|
2
|
|
lumbar side flexion
|
> 10 cm
|
0
|
|
|
5 - 10 cm
|
1
|
|
|
< 5 cm
|
2
|
|
intermalleolar distance
|
> 100 cm
|
0
|
|
|
70 - 100 cm
|
1
|
|
|
< 70 cm
|
2
|
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the more severe the ankylosing spondylitis.
