Spondyloarthropathy classification
Classification
|
Spondyloarthropathy Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Spondyloarthropathy classification On the Web |
|
American Roentgen Ray Society Images of Spondyloarthropathy classification |
|
Risk calculators and risk factors for Spondyloarthropathy 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 has its own criteria to define, which are included:
| 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 | ||
Spectrum of Spondyloarthropathies are included:
- Ankylosing spondylitis
- Axial spondylitis
- Peripheral spondylitis
- spondylitis in general
- Psoriatic arthritis
Criteria for defining Ankylosing spondylitis is:
| Modified New York criteria for ankylosing spondylitis |
|---|
| Low back pain for at least 3 mo duration improved by exercise and not received with rest |
| Limitation of lumbar spine motion in sagittal and frontal planes Chest expansion decreased relative to normal values for age and sex
Unilateral sacroiliitis grade 3–4 Bilateral sacroiliitis grade 2–4 Definite ankylosing spondylitis if and any clinical criterion |