Spondyloarthropathy history and symptoms

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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