Spondyloarthropathy history and symptoms
|
Spondyloarthropathy Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Spondyloarthropathy history and symptoms On the Web |
|
American Roentgen Ray Society Images of Spondyloarthropathy history and symptoms |
|
Risk calculators and risk factors for Spondyloarthropathy history and symptoms |
History and symptoms
The most important key components of patient history that increase the probability of Spondyloarthropathy (SpA) are included as the following:
- Subtle onset of low back pain
- Age < 40
- Presence of symptoms >3 mo
- Stiffness and severity of symptoms in the morning
- improvement of symptoms with exercise
General symptom of SpA are included:
- Inflammatory back pain → the most common symptom
- Chronic pain and stiffness → in more than 70% of patients
- Chronic Fatigue → in more than 60 % of patients
- Fever
- With loss
Inflammatory back pain
Inflammatory back pain is the most common symptoms (approximately 75%) that has been seen among patient with SpA. The feature of this pain is not localized but it is somehow limited to gluteal and sacroiliac areas.
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" | New criteria for diagnosis of IBP | ||
| Age at onset <40 yr | Morning stiffness of >30 min duration | Insidious onset | Improvement with exercise | ||
| Duration of back pain >3 months | Improvement in back pain with exercise but not with rest | Pain at night (with improvement upon getting up) | Pain at night | ||
| Insidious onset Morning stiffness | Nocturnal awakening (second half of the night only) | Age at onset < 40 yr | Insidious onset | ||
| Improvement with exercise | Alternating buttock pain | Improvement with exercise | Age <40 yr | ||
| 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 | No improvement with rest | ||
| 4 of 5 criteria eventuate in sensitivity 79.6% and specificity 72.4% | |||||
| IBP: Inflammatory back pain; ASAS: Assessment of spondyloarthritis international society; iPAIN: Inflammatory PAIN | |||||