Spondyloarthropathy classification: Difference between revisions

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* HLA-B27
* HLA-B27
* Elevated CRP
* Elevated CRP
{| style="border: 3px; font-size; 190%; margin: 1px; width: 600px" align="center"
! colspan="3" style="background: #5579FF; width: 600px:" | {{fontcolor|#FFF|Inflammatory back pain criteria sets and mnemonic for assessment of spondyloarthritis international society criteria}}
|-
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Calin's criteria for IBP}}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Berlin criteria for IBP}}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|ASAS IBP criteria mnemonic for criteria "iPAIN"}}
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Age at onset <40 yr
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Morning stiffness of >30 min duration
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Insidious onset
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Duration of back pain >3 months
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Improvement in back pain with exercise but not with rest
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Pain at night (with improvement upon getting up)
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Insidious onset Morning stiffness
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Nocturnal awakening (second half of the night only)
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Age at onset < 40 yr
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Improvement with exercise
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Alternating buttock pain
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Improvement with exercise
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Requires the presence of four of  ve criteria
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |The sensitivity is 70% speci city 81% if two of the four criteria are fulfilled
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |No improvement with rest The sensitivity is 77.0% and speci city 91.7% if at least four out of  ve criteria are fulfilled
|-
! colspan="3" style="background: #5579FF; width: 600px:" | {{fontcolor|#FFF|IBP: Inflammatory back pain; ASAS: Assessment of spondyloarthritis international society; iPAIN: Inflammatory PAIN}}
|}

Revision as of 21:42, 26 August 2018

Classification

spondyloarthropathies (SpA) are a group of inflammatory arthritis that consist of ankylosing spondylitis (AS), juvenile onset arthritis, reactive arthritis, non-radiographic ankylosing spondylitis, psoriasis arthritis, and inflammatory bowel disease associated arthritis.

Classification criteria ,that combine different type of information such as imaging, laboratory findings, symptoms, and signs, have been made to describe and define groups for better understanding of clinical and epidemiological studies.

Assessment of spondyloarthritis international society (ASAS criteria) have been widely used to classify the axial spondyloarthritis, which have been described as back pain more than or equal to 3 months and age of onset less than 45 years. ASAS suggest these two sort of criteria:

  • Sacroiliitis on imaging plus 1 SpA feature. or
  • HLA-B27 plus 2 other SpA features

Sacroiliitis on imaging will be describe as:

  • Active inflammation on MRI highly suggested of SpA-assocoated sacroiliitis and/or
  • Definite radiograohic sacroiliitis

SpA features:

  • Inflammatory back pain
  • Arthritis
  • Enthesitis
  • Anterior uveitis
  • Dactylitis
  • Psoriasis
  • Crohn's disease or ulcerative colitis
  • Good response to NSAID
  • Family history of SpA
  • HLA-B27
  • Elevated CRP
Inflammatory back pain criteria sets and mnemonic for assessment of spondyloarthritis international society criteria
Calin's criteria for IBP Berlin criteria for IBP ASAS IBP criteria mnemonic for criteria "iPAIN"
Age at onset <40 yr Morning stiffness of >30 min duration Insidious onset
Duration of back pain >3 months Improvement in back pain with exercise but not with rest Pain at night (with improvement upon getting up)
Insidious onset Morning stiffness Nocturnal awakening (second half of the night only) Age at onset < 40 yr
Improvement with exercise Alternating buttock pain Improvement with exercise
Requires the presence of four of ve criteria The sensitivity is 70% speci city 81% if two of the four criteria are fulfilled No improvement with rest The sensitivity is 77.0% and speci city 91.7% if at least four out of ve criteria are fulfilled
IBP: Inflammatory back pain; ASAS: Assessment of spondyloarthritis international society; iPAIN: Inflammatory PAIN