Akademik Veri Yönetim Sistemi
Journal of Turkish Society For Rheumatology, cilt.18, sa.1, ss.89-97, 2026 (Scopus, TRDizin)
Objective: To compare the clinical, functional, and radiological features of patients with radiographic axial spondyloarthritis (r-AxSpA) according to the presence of sacroiliac joint (SIJ) ankylosis. Methods: This retrospective study included 290 patients fulfilling the modified New York criteria for ankylosing spondylitis. SIJ ankylosis was defined on pelvic radiographs as unilateral or bilateral grade 4 sacroiliitis. Patients with unilateral and bilateral ankylosis were initially analysed together as the overall ankylosis group and compared with patients without ankylosis; subsequently, a separate subgroup analysis was performed focusing exclusively on patients with bilateral ankylosis. Clinical, functional, radiographic, and treatment-related characteristics were compared between groups. Results: Among 290 patients, 30 (10.3%) had unilateral and 101 (34.8%) had bilateral sacroiliac ankylosis. Compared with patients without ankylosis, patients with sacroiliac ankylosis showed a male predominance, longer symptom and disease duration, and higher rates of smoking, alcohol consumption, hip involvement, sacral enthesitis, and syndesmophytes. Human leukocyte antigen B27 positivity was increased in patients with sacroiliac ankylosis overall but was not significantly associated in the bilateral ankylosis group. Symptom and disease duration were positively correlated with Bath Ankylosing Spondylitis Metrology Index and modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS), whereas spinal mobility measures were negatively correlated, with stronger associations observed in the bilateral ankylosis group. In multivariable models, total mSASSS and hip involvement were independently associated with bilateral sacroiliac ankylosis. Conclusion: SIJ ankylosis, particularly when bilateral, is associated with more extensive structural damage and impaired spinal mobility in r-AxSpA.