The European Spondylarthropathy Study Group Preliminary Criteria for the Classification of Spondylarthropathy

Abstract

Classification criteria for most of the disorders belonging to the spondylarthropathy group already exist. However, the spectrum of spondylarthropathy is wider than the sum of these disorders suggests. Seronegative oligoarthritis, dactylitis or polyarthritis of the lower extremities, heel pain due to enthesitis, and other undifferentiated cases of spondylarthropathy have been ignored in epidemiologic studies because of the inadequacy of existing criteria. In order to define classification criteria that also encompass patients with undifferentiated spondylarthropathy, we studied 403 patients with all forms of spondylarthropathy and 674 control patients with other rheumatic diseases. The diagnoses were based on the local clinical expert's opinion. The 403 patients included 168 with ankylosing spondylitis, 68 with psoriatic arthritis, 41 with reactive arthritis, 17 with inflammatory bowel disease and arthritis, and 109 with unclassified spondylarthropathy . Based on statistical analysis and clinical reasoning, we propose the following classification criteria for spondylarthropathy : inflammatory spinal pain or synovitis (asymmetric or predominantly in the lower limbs), together with at least 1 of the following: positive family history, psoriasis, inflammatory bowel disease, urethritis, or acute diarrhea, alternating buttock pain, enthesopathy, or sacroiliitis as determined from radiography of the pelvic region. These criteria resulted in a sensitivity of 87% and a specificity of 87%. The proposed classification criteria are easy to apply in clinical practice and performed well in all 7 participating centers. However, we regard them as preliminary until they have been further evaluated in other settings.From the European Spondylarthropathy Study Group (ESSG).

Absence of a classically activated macrophage cytokine signature in peripheral spondylarthritis, including psoriatic arthritis

“…The study included 55 patients with RA who fulfilled the American College of Rheumatology (formerly, the American Rheumatism Association) criteria (12) and 47 patients with SpA who fulfilled the European Spondylarthropathy Study Group criteria (13), but excluding patients with PsA. Although the SpA patients were primarily selected according to the presence of peripheral disease, 32 of the 47 patients had inflammatory back pain and 15 of the 47 patients clearly had sacroiliitis according to conventional radiographs.…”

Serum macrophage inhibitory cytokine 1 in rheumatoid arthritis: A potential marker of erosive joint destruction

“…All patients were recruited and their samples obtained with the approval of St. Vincent's Hospital or the participating hospital's ethics committee. RA patients met the American College of Rheumatology (ACR; formerly, the American Rheumatism Association) 1987 revised criteria for the classification of RA (31), while patients with reactive arthritis (ReA) met appropriate criteria for this condition (32).…”

Evaluation of the european spondylarthropathy study group preliminary classification criteria in alaskan eskimo populations

“…Their records were also reviewed thoroughly. Throughout the study we adhered to the definitions specified by the ESSG for each of the variables (5). Standard anteroposterior radiographs of the pelvis, for examination of the sacroiliac (SI) joints, were performed only when clinically indicated, in accordance with our human research committee guidelines.…”