Can some cases of 'possible' spondyloarthropathy be classified as 'definite' or 'undifferentiated' spondyloarthropathy? Value of criteria for spondyloarthropathies
E. Collantes et al., Can some cases of 'possible' spondyloarthropathy be classified as 'definite' or 'undifferentiated' spondyloarthropathy? Value of criteria for spondyloarthropathies, JOINT BONE, 67(6), 2000, pp. 516-520
Objectives. When evaluating patients for spondyloarthropathy, clinicians us
e the 'possible spondyloarthropathy' category to indicate that they are uns
ure about the diagnosis. We sought to determine whether Amor's criteria or
the European Spondyloarthropathy Study Group (ESSG) criteria could lift thi
s uncertainty. Patients and methods. During a Spanish study designed to val
idate criteria for spondyloarthropathies, 102 patients were classified in t
he 'possible spondyloarthropathy' category. We divided these patients into
subgroups based on whether or not they met criteria for spondyloarthropathy
. We compared baseline characteristics (N = 102) and five-year outcomes (N
= 52) in these subgroups. Results. The following features were significantl
y more common in the subgroups of patients who met Amor's criteria for spon
dyloarthropathy: oligoarthritis, heel pain, uveitis, balanitis, family hist
ory of spondyloarthropathy, and presence of the HLA B27 antigen. No differe
nces were found for age at symptom onset, disease duration, buttock pain, g
ender, dactylitis, diarrhea, or psoriasis. Of the 52 patients followed up f
or five years, 17 met Amor's criteria at baseline and 13 were subsequently
found to have definite spondyloarthropathy, which was undifferentiated in s
ix cases. There were only three cases of spondyloarthropathy among the 28 p
atients who did not meet Amor's criteria at baseline. Of the 28 patients wh
o met ESSG criteria at baseline, 13 had spondyloarthropathy versus three of
the 17 patients who did not meet ESSG criteria at baseline. Conclusion. Am
or's criteria or the ESSG criteria allow early classification of most patie
nts with 'possible spondyloarthropathy' and early identification of undiffe
rentiated spondyloarthropathy corresponding to minimal-symptom or incipient
disease, in this study, Amor's criteria performed better than the ESSG cri
teria. (C) 2000 Editions scientifiques et medicales Elsevier SAS.