Spondyloarthritis Redefined: New Diagnostic Classifications

Jun 15, 2018

New classification criteria for spondyloarthritis cover a wide spectrum of patients.

Sources
• Malaviya AN, Kalyani A, Rawat R, Gogia SB. Comparison of patients with ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA) from a single rheumatology clinic in New Delhi. Int J Rheum Dis. 2015;18:736-741.
• Malaviya AN, Rawat R, Agrawal N, Patil NS. The nonradiographic axial spondyloarthritis, the radiographic axial spondyloarthritis, and ankylosing spondylitis: the tangled skein of rheumatology. Int J Rheumatol. 2017;2017:1824794.
• Raychaudhuri SP, Deodhar A. The classification and diagnostic criteria of ankylosing spondylitis. J Autoimmun. 2014;48-49:128-133.

Spondyloarthritis (SpA) encompasses a large group of genetically related immune-mediated rheumatologic disorders, including ankylosing spondylitis (AS), spondylitis related to psoriatic arthritis (PsA), inflammatory bowel disease (IBD), and reactive arthritis (ReA).

There are no clear diagnostic tests for spondyloarthritis. The term axial spondyloarthritis is now used to describe primary inflammatory disease of the spine and sacroiliac joints, either with or without radiographic signs. Other forms involving peripheral arthritis, enthesitis, or dactylitis are defined as peripheral spondyloarthritis.

Ankylosing spondylitis (AS) represents the most severe and advanced stage of axial SpA, and it produces significant pain that interferes with mobility. Although 90% of patients with AS carry the HLA-27 gene, only 1 in 15 with the gene will develop AS.

ASAS, Assessment of Spondyloarthritis International Society; NSAID, nonsteroidal anti-inflammatory drug; SpA, spondyloarthritis.

ASAS, Assessment of Spondyloarthritis International Society; SpA, spondyloarthritis.

ASAS, Assessment of Spondyloarthritis International Society; IBD, inflammatory bowel disease; SpA, spondyloarthritis.