Classification criteria for spondyloarthropathies

Table 1 Inflammatory back pain criteria sets and mnemonic for assessment of spondyloarthritis international society criteria[11-13,17]

Calin’s criteria for IBP	Berlin criteria for IBP	ASAS IBP criteria mnemonic for criteria “iPAIN”
Age at onset < 40 yr	Morning stiffness of > 30 min duration	Insidious onset
Duration of back pain > 3 mo	Improvement in back pain with exercise but not with rest	Pain at night (with improvement upon getting up)
Insidious onset
Morning stiffness	Nocturnal awakening (second half of the night only)	Age at onset < 40 yr
Improvement with exercise	Alternating buttock pain	Improvement with exercise
		No improvement with rest
Requires the presence of four of five criteria	The sensitivity is 70% specificity 81% if two of the four criteria are fulfilled	The sensitivity is 77.0% and specificity 91.7% if at least four out of five criteria are fulfilled

IBP: Inflammatory back pain; ASAS: Assessment of spondyloarthritis international society; iPAIN: Inflammatory PAIN.

Table 2 Modified New York criteria for ankylosing spondylitis[16]

Low back pain for at least 3 mo duration improved by exercise and not relieved by rest
Limitation of lumbar spine motion in sagittal and frontal planes
Chest expansion decreased relative to normal values for age and sex
Unilateral sacroiliitis grade 3–4
Bilateral sacroiliitis grade 2–4
Definite ankylosing spondylitis if (4a or 4b) and any clinical criterion (1–3)

Table 3 Amor criteria for the classification of spondyloarthropathies[28]

Amor criteria
Clinical symptoms or history of scoring	Points
Lumbar or dorsal pain at night or morning stiffness of lumbar or dorsal pain	1
Asymmetrical oligoarthritis	2
Buttock pain	1
If alternate buttock pain	2
Sausage like toe or digit	2
Heel pain or other well-defined enthesopathy	2
Iritis	1
Nongonococcal urethritis or cervicitis within 1 mo before the onset of arthritis	1
Acute diarrhea within one month before the 1 mo onset of arthritis	1
Psoriasis, balanitis, or inflammatory bowel disease (ulcerative colitis or Crohn’s disease)	2
Radiological findings
Sacroiliitis (bilateral grade 2 or unilateral grade 3)	3
Genetic background
Presence of HLA-B27 and/or family history of ankylosing spondylitis, reactive arthritis, uveitis, psoriasis, or inflammatory bowel disease	2
Response to treatment
Clear-cut improvement within 48 h after NSAIDs intake or rapid relapse of the pain after their discontinuation	2
A patient is considered as suffering from a pondyloarthropathy if the sum is ≥ 6

NSAID: Nonsterodial anti-inflammatory drug; HLA: Human leukocyte antigen.