van der Linden et al proposed a modification to the original New York criteria for ankylosing spondylitis. This replaces the original New York pain criterion with the pain criterion from the Rome criteria. The authors are from the Erasmus University in Rotterdam.
Clinical criteria:
(1) Low back pain and stiffness for more than 3 months which improves with exercise but which is not relieved by rest.
(2) Limitation of motion of the lumbar spine in both the sagittal and frontal planes.
(3) Limitations of chest expansion relative to normal values corrected for age and sex.
Measurement of chest expansion needs to be standardized to minimize variability.
(1) This is measured in the 4th intercostal space
(2) van der Linden measured the expansion twice, taking the larger of the 2.
(3) The result is compared with tables broken down by age and sex (Moll and Wright, 1972; Moll and Wright, 1973). Using 1 inch (2.5 cm) as the measure was specific but insensitive.
Radiographic criteria:
(1) bilateral sacroiliitis >= Grade 2
(2) unilateral sacroiliitis >= Grade 3
Definite anklyosing spondylitis
(1) >= 1 clinical criterion AND 1 radiologic criteria
Probable ankylosing spondylitis
(1) 3 clinical criteria AND no radiologic criteria
(2) 1 radiologic criterion is present AND no clinical criteria
