Spondyloarthropathy diagnostic study of choice: Difference between revisions
Jump to navigation
Jump to search
(Created page with "==Diagnostic study of choice==") |
|||
| (3 intermediate revisions by the same user not shown) | |||
| Line 1: | Line 1: | ||
==Diagnostic study of choice== | ==Diagnostic study of choice== | ||
{{Spondyloarthropathy}}European League Against Rheumatism reported that the first line of study in in patient with whom suspicious for Spondyloarthropathy is conventional radiography of sacroiliac joints. It has also recommended Magnetic Resonance Imaging (MRI) in the following situations: | |||
* Young patient with new onset of symptoms. | |||
* If the conventional radiography is not diagnostic, but there is strong clinical suspicious. | |||
* To see acute or chronic features of disease ( bone marrow edema, bone erosion or new bone formation ) | |||
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 | |||
|- | |||
|} | |||
Latest revision as of 12:06, 29 August 2018
Diagnostic study of choice
|
Spondyloarthropathy Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Spondyloarthropathy diagnostic study of choice On the Web |
|
American Roentgen Ray Society Images of Spondyloarthropathy diagnostic study of choice |
|
Risk calculators and risk factors for Spondyloarthropathy diagnostic study of choice |
European League Against Rheumatism reported that the first line of study in in patient with whom suspicious for Spondyloarthropathy is conventional radiography of sacroiliac joints. It has also recommended Magnetic Resonance Imaging (MRI) in the following situations:
- Young patient with new onset of symptoms.
- If the conventional radiography is not diagnostic, but there is strong clinical suspicious.
- To see acute or chronic features of disease ( bone marrow edema, bone erosion or new bone formation )
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 | ||||