Spondylarthropathy Diagnosis Criteria

Criteria for diagnosis:

(1) one or more findings from Group A

(2) one or more findings from Group B

Group A:

(1) inflammatory spinal pain

(2) asymmetrical synovitis

(3) synovitis, predominantly in the lower limbs

Group B:

(1) buttock pain alternating between right and left gluteal areas

(2) sacroiliitis

(3) enthesopathy

(4) positive family history

(5) psoriasis

(6) inflammatory bowel disease

(7) urethritis or cervicitis or acute diarrhea occurring within 1 month before arthritis

Definitions (Table 5, page 1223, Dougados, 1991):

(1) inflammatory spinal pain: history or present symptoms of spinal pain in the back, dorsal or cervical region, with at least 4 of the following: (a) onset before age 45, (b) insidious onset, (c) improved by exercise, (d) associated with morning stiffness, (e) at least 3 months duration

(2) synovitis: past or present asymmetric arthritis or arthritis predominantly in the lower limbs

(3) family history: presence in a first-degree or second-degree relative of any of the following: (a) ankylosing spondylitis, (b) psoriasis, (c) acute uveitis, (d) reactive arthritis, (e) inflammatory bowel disease

(4) psoriasis: past or present psoriasis diagnosed by a physician

(5) inflammatory bowel disease: past or present Crohn's disease or ulcerative colitis diagnosed by a physician and confirmed by radiographic examination or endoscopy

(6) alternating buttock pain: past or present pain alternating between right and left gluteal regions

(7) enthesopathy: past or present spontaneous pain or tenderness at examination of the site of the insertion of the Achilles tendon or plantar fascia

(8) acute diarrhea: episode of diarrhea occurring within 1 month before arthritis

(9) urethritis or cervicitis: nongonococcal inflammation occurring within 1 month before arthritis

(10) sacroiliitis: bilateral grade 2-4 or unilateral grade 3-4, according to radiographic grading system of 0 = normal, 1 = possible, 2 = minimal, 3 = moderate, 4 = ankylosis.