Description

Amor et al developed a scoring system for the diagnosis of spondylarthropathy based on clinical, radiologic, genetic and therapeutic criteria. The authors are from Paris, France.


Parameters (12 items):

(1) clinical symptoms, current or past history of: 9 items

(2) radiological findings: 1 item

(3) genetic background: 1 item

(4) response to treatment: 1 item

 

Parameter

Finding

Points

lumbar or dorsal pain at night or morning stiffness of lumbar or dorsal pain

present

1

 

absent

0

asymmetrical oligoarthritis

present

2

 

absent

0

buttock pain

none

0

 

present

1

 

alternating between left and right sides

2

sausage-like toe or digit

present

2

 

absent

0

heel pain or other well-defined enthesiopathic pain

present

2

 

absent

0

iritis

present

2

 

absent

0

non-gonococcal urethritis or cervicitis within 1 month before the onset of arthritis

present

1

 

absent

0

history of acute diarrhea within 1 month before the onset of arthritis

present

1

 

absent

0

psoriasis, balanitis, or inflammatory bowel disease (ulcerative colitis or Crohn's disease)

present

2

 

absent

0

sacroiliitis

bilateral >= 2

2

 

unilateral >= 3

2

 

other

0

genetic background

HLA-B27

2

 

family history of ankylosing spondylitis, reactive arthritis, uveitis, psoriasis or inflammatory bowel disease

2

 

neither

0

response to NSAID intake

clear-cut improvement within 48 hours

2

 

rapid relapse on discontinuation

2

 

neither

0

 

where:

• Buttock pain in the table from Dougados has "if alternate buttock pain" as 2 points. The ESSG criteria defines pain alternating between the right and left gluteal regions.

• Enthesitis: inflammation of the muscular or tendinous attachment to bone.

 

score =

= SUM(points for all 12 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 21

• A score >= 6 indicates that the patient has a spondylarthropathy.


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