Spondyloarthropathies differential diagnosis

Spondyloarthropathies differential diagnosis

The diagnosis of spondyloarthropathies are generally based on the various clinical criteria and some symptoms and signs such as Inflammatory back pain enthesitis or arthritis with radiographic findings.

Spectrum of Spondyloarthropathies are included:

• Ankylosing spondylitis
• Axial spondylitis
• Peripheral spondylitis
• spondylitis in general
• Psoriatic arthritis

Here are some clinical criteria which have been made throughout different studies to make the diagnosis even more specific and sensitive. These criteria are: 1-ESSG ( The European spondyloarthropathy study group) 2- Amor criteria 3- New York criteria 4- Rome criteria

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