Spondyloarthropathy diagnostic study of choice: Difference between revisions

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==Diagnostic study of choice==
==Diagnostic study of choice==
The basis of the diagnosis of spondyloarthropathy is clinical. Clinical criteria have been made to increase the specificity and sensitivity of the evaluation of clinical symptoms and signs. These criteria are included:
The basis of the diagnosis of spondyloarthropathy is clinical. Clinical criteria have been made to increase the specificity and sensitivity of the evaluation of clinical symptoms and signs. These criteria are included:
{| style="border: 3px; font-size; 190%; margin: 1px; width: 900px" align="center"
! colspan="5" style="background: #ffa500; width: 900px:" | {{fontcolor|#FFF|ESSG, Amor, New York, and Rome criteria for diagnosis of Spondyloarthropathies}}
|-
! style="background: #1e90ff; width: 200px;" | {{fontcolor|#FFF|Amor Criteria}}
! style="background: #1e90ff; width: 200px;" | {{fontcolor|#FFF|ESSG Criteria}}
! style="background: #1e90ff; width: 200px;" | {{fontcolor|#FFF|Points}}
! style="background: #1e90ff; width: 200px;" | {{fontcolor|#FFF|New York Criteria}}
! style="background: #1e90ff; width: 200px;" | {{fontcolor|#FFF|Rome Criteria}}
|-
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Inflammatory back pain
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Inflammatory spinal pain or synovitis and one of the following:
| style="padding: 5px 5px; background: #00FA9A; " align="center" |1 point
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Low back pain with inflammatory characteristics
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Low back pain and stiffness for >3 mo that is not relieved by rest
|-
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Unilateral buttock pain
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Alternating buttock pain
| style="padding: 5px 5px; background: #00FA9A; " align="center" |1 point
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Limitation of lumbar spine motion in sagittal and frontal planes
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Pain and stiffness in the thoracic region
|-
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Alternating buttock pain
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Enthesitis
| style="padding: 5px 5px; background: #00FA9A; " align="center" |2 point
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Decreased chest expansion
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Limited motion in the lumbar spine
|-
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Enthesitis
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Sacroiliitis
| style="padding: 5px 5px; background: #00FA9A; " align="center" |2 point
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Bilateral sacroiliitis grade 2 or higher
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Limited chest expansion
|-
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Peripheral arthritis
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |IBD
| style="padding: 5px 5px; background: #00FA9A; " align="center" |2 point
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Unilateral sacroiliitis grade 3 or higher
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |History of uveitis
|-
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Dactylitis (sausage digit)
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Positive family history of spondyloarthropathy
| style="padding: 5px 5px; background: #00FA9A; " align="center" |2 point
| style="padding: 5px 5px; background: #ffd700; " align="center" |Definite ankylosing spondylitis when the fourth or fifth criterion mentioned above presents with any clinical criteria
| style="padding: 5px 5px; background: #ffd700; " align="center" |Diagnosis of ankylosing spondylitis when any clinical criteria present with bilateral sacroiliitis grade 2 or higher
|-
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Acute anterior uveitis
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |
| style="padding: 5px 5px; background: #00FA9A; " align="center" |2 point
|-
| style="padding: 5px 5px; background: #DCDCDC; " align="center" | HLA-B27 positive or family history of spondyloarthropathy
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |
| style="padding: 5px 5px; background: #00FA9A; " align="center" |2 point
|-
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |Good response to NSAID
| style="padding: 5px 5px; background: #DCDCDC; " align="center" |
| style="padding: 5px 5px; background: #00FA9A; " align="center" | 2 point
|-
! colspan="3" style="background: #ffd700; width: 900px:" align="center" |Diagnosis of Spondyloarthropathy with 6 or more points
|-
|}

Revision as of 11:22, 29 August 2018

Diagnostic study of choice

The basis of the diagnosis of spondyloarthropathy is clinical. Clinical criteria have been made to increase the specificity and sensitivity of the evaluation of clinical symptoms and signs. These criteria are included:

ESSG, Amor, New York, and Rome criteria for diagnosis of Spondyloarthropathies
Amor Criteria ESSG Criteria Points New York Criteria Rome Criteria
Inflammatory back pain Inflammatory spinal pain or synovitis and one of the following: 1 point Low back pain with inflammatory characteristics Low back pain and stiffness for >3 mo that is not relieved by rest
Unilateral buttock pain Alternating buttock pain 1 point Limitation of lumbar spine motion in sagittal and frontal planes Pain and stiffness in the thoracic region
Alternating buttock pain Enthesitis 2 point Decreased chest expansion Limited motion in the lumbar spine
Enthesitis Sacroiliitis 2 point Bilateral sacroiliitis grade 2 or higher Limited chest expansion
Peripheral arthritis IBD 2 point Unilateral sacroiliitis grade 3 or higher History of uveitis
Dactylitis (sausage digit) Positive family history of spondyloarthropathy 2 point Definite ankylosing spondylitis when the fourth or fifth criterion mentioned above presents with any clinical criteria Diagnosis of ankylosing spondylitis when any clinical criteria present with bilateral sacroiliitis grade 2 or higher
Acute anterior uveitis 2 point
HLA-B27 positive or family history of spondyloarthropathy 2 point
Good response to NSAID 2 point
Diagnosis of Spondyloarthropathy with 6 or more points