Evaluation of Vertebrae in Patients With Ankylosing Spondylitis Using Hounsfield Unit Values

ABSTRACT Objective To evaluate vertebral Hounsfield Unit (HU) values on computed tomography (CT) in patients with ankylosing spondylitis (AS) compared to patients without AS and to examine differences in HU values between ankylosed and nonankylosed vertebrae in patients with AS. Methods This cross‐sectional study included 34 patients with AS and 73 patients without AS who underwent spinal CT between 2004 and 2022. HU values were measured from C3 to L5 in patients with AS and from L1 to L5 in patients without AS. Propensity score (PS) matching based on age and sex was performed to compare HU values between groups. Additionally, HU values were compared between ankylosed and nonankylosed vertebrae within the AS group. Results After PS matching, vertebral HU values were significantly lower in patients with AS than in patients without AS (136.4 vs. 197.1, p = 0.009). Among patients with AS, HU values were highest in the cervical spine, followed by the thoracic and lumbar regions. Ankylosed vertebrae showed significantly lower HU values than nonankylosed vertebrae across all spinal levels ( p < 0.001). Conclusion Vertebral HU values were lower in patients with AS compared to age‐ and sex‐matched patients without AS. HU values were highest in the cervical spine, and ankylosed vertebrae consistently exhibited lower HU values than nonankylosed vertebrae across all spinal regions.