1 Before you use it
What it is
Six questions on the last week — fatigue, spinal pain, peripheral joint pain and swelling, areas of localised tenderness, and morning stiffness (severity and duration).
The standard disease-activity measure in axial spondyloarthritis, and the one that tells you whether the medical management is working.
When to reach for it
Any patient with known or suspected axial spondyloarthritis, at baseline and review.
Suspicion alone is a referral, not a BASDAI. Inflammatory back pain features — under 40 at onset, insidious, better with exercise and worse with rest, night pain, prolonged morning stiffness — belong in a rheumatology letter.
Patterns it serves · 1
2 Giving it
Scoring
Six 0–10 items. The two morning-stiffness items are averaged into one, then the five resulting values are averaged to give 0–10.
That averaging step is where students get it wrong.
What it doesn’t measure
Function — that is BASFI. Spinal mobility — that is BASMI. And it does not diagnose. The three Bath measures are designed to be used together.
Repeat it
3 Reading the score
Interpreting it
A score of 4 or above is conventionally used as the threshold for active disease and as one trigger for escalating medical therapy.
Morning stiffness duration is the item to watch clinically. UniSA coding: over 30 minutes is In — and in this population it is a disease-activity signal rather than a mechanical one.
Is the change real?
On placement
Ankylosing spondylitis, on a biologic and a loading programme. BASDAI 5.2 at intake, 4.0 at the 12-week review.
Read it as 1.2 points down on a 0–10 scale — 12 mm on the 100 mm items, and a 23% relative change. Both sides of the verified MCID (10 mm or 22.5%, measured in ankylosing spondylitis) are cleared, just. The 4.0 also sits on the conventional active-disease threshold, so this is a patient who moved but is not out of the woods.
Do report it to the rheumatology team with the morning-stiffness item pulled out — that item is the disease-activity signal — and keep the programme going.
Student trap. Averaging all six items straight. The two stiffness items are combined first — do it in the wrong order and every score you record is wrong.
Official source: basdai.com. We don't host the form.
This is a learning tool. It does not diagnose patients and does not replace your clinical educator.
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