The Bath Ankylosing Spondylitis Metrology Index (BASMI)

  1. Cervical Rotation
    This is measured with a gravity action goniometer, the mean of right and left results being calculated. The patient lies supine in the neutral position and the goniometer is placed centrally on the forehead. The patient is then asked to turn the head as far as possible to the right and then to the left.
    * View cervical rotation using a Goniometer.
  2. Tragus to wall distance
    For the measurement of tragus to wall distance the patient stands with heels and buttocks touching the wall, knees straight, shoulders back and places the head as far back as possible, keeping the chin in.
    * View Tragus to Wall distance.
  3. Lateral Spinal Flexion
    This is measured by fingertip to floor distance in full lateral flexion without flexing forward or bending the knees, using a rule mounted on a floor stand. The patient bends laterally to push the middle finger of the right or left hand down the rule and the difference between start and end points is recorded and the mean calculated.
    * View Lateral Lumbar flexion BASMI approach.
  4. Lumbar Flexion
    Lumbar flexion is assessed by the Macrae and Wright modification of the Schober index. A mark is placed at the lumbosacral junction, which is represented by the spinal intersection of a line joining the dimples of Venus. Further marks are placed 5 cm below and 10 cm above the lumbosacral junction. The patient is asked to bend forwards as far as possible, keeping the knees straight, and the distraction between these 2 marks is recorded.
    * View Schober's test.
  5. Intermalleolar distance
    This is measured with the patient supine, the knees straight and the feet pointing straight up. The patient is asked to separate the legs as far as possible and the distance between the medial malleoli is measured.
    * View BASMI intermalleolar distance.

Reference: Jenkinson TR, Mallorie PA, Whitelock HC, Kennedy LG, Garrett SL, Calin A. Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS metrology index. J Rheumatol 1994; 21: 1694-1698

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