Letter: The Value of Trabecular Bone Score in the Evaluation of Bone Quality in a Patient with Ankylosing Spondylitis

Dear Editor, Patients with ankylosing spondylitis (AS) have an increased risk of developing osteoporosis, mainly caused by systemic inflammation and decreased mobility. For this reason, patients with AS demonstrate an increased risk of fractures, especially vertebral fractures, in comparison with the general population. However, measurements of areal bone mineral density (aBMD) are overestimated and unreliable in AS patients, because of the presence of osteo-proliferation and syndesmophytes. Significantly increased aBMD measures have been reported in patients with advanced AS. Consequently, the diagnosis of osteoporosis could be difficult in affected patients.