American Board of Internal Medicine (ABIM) Certification Practice Exam

In patients with ankylosing spondylitis responding well to treatment, how often should they have periodic imaging studies?

1. Every 6 months

2. Every year

3. Every 2 years

4. Only as needed

The correct answer is: Every 2 years

For patients with ankylosing spondylitis who are responding well to treatment, it is generally recommended to perform imaging studies every two years. This interval allows for adequate monitoring of disease progression and assessment of new changes in the spine or pelvis, particularly in the context of potential radiographic findings like sacroiliitis or syndesmophytes. This approach maintains a balance between the need for ongoing assessment and the avoidance of excessive imaging, which can expose patients to unnecessary radiation and healthcare costs. Imaging at this frequency provides sufficient data to ensure that any significant changes in disease activity can be detected and addressed with their healthcare provider in a timely manner. While it is important for clinicians to remain aware of changes in a patient’s symptoms or physical exam findings, the recommendation for imaging every two years supports a proactive yet judicious approach in managing ankylosing spondylitis, especially in those who demonstrate a stable disease state.