_id

683a15f1c782e11e38d1b0b0

id

306

title

ASAS Criteria for Axial Spondyloarthritis (SpA)

full_title

ASAS Criteria for Axial Spondyloarthritis (SpA)

short_title

ASAS Criteria for Axial SpA

med_description

Classifies axial spondyloarthritis according to Assessment of Spondyloarthritis International Society (ASAS) criteria.

short_description

Axial SpA classification.

slug

asas-criteria-axial-spondyloarthritis-spa

description

The ASAS Criteria for Axial Spondyloarthritis (SpA) diagnoses axial spondyloarthritis according to Assessment of Spondyloarthritis International Society (ASAS) criteria.

keywords

Spondyloarthritis, spa, spondylitis, sacroiliitis, si joint

complaint

[ "Pain" ]

formula

Entry criterion:

Back pain ≥3 months and age at onset <45 years

Required criteria:

Sacroiliitis on imaging* plus ≥1 SpA feature, or

HLA-B27 plus ≥2 additional SpA features

SpA features:

• Inflammatory back pain
• Arthritis
• Enthesitis (heel)
• Uveitis
• Dactylitis
• Psoriasis
• Crohn’s disease or ulcerative colitis
• Good response to NSAIDs
• Family history of SpA
• HLA-B27
• Elevated CRP

*Active (acute) inflammation on MRI highly suggestive of SpA-associated sacroiliitis, or definite radiographic sacroiliitis according to modified New York criteria (bilateral grade 2-4 sacroiliitis or unilateral grade 3-4 sacroiliitis, Van Der Linden 1984).

evidence

measurements

[]

information

refrences

{ "Clinical Practice Guidelines": [ { "href": "https://www.rheumatology.org/Portals/0/Files/Recommendations%20for%20the%20Treatment%20of%20Ankylosing%20Spondylitis.pdf ", "text": "Ward MM, Deodhar A, Akl EA, et al. American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis. Arthritis Rheumatol. 2016;68(2):282-98." } ], "Manufacturer Website": [ { "href": "", "text": "" } ], "Original/Primary Reference": [ { "href": "https://ard.bmj.com/content/annrheumdis/68/6/777.full.pdf ", "text": "Rudwaleit M, Van Der Heijde D, Landewé R, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009;68(6):777-83." } ], "Other References": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/6231933 ", "text": "Van Der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 1984;27(4):361-8." } ], "Outcomes": [ { "href": "", "text": "" } ], "Validation": [ { "href": "", "text": "" } ], "Validations": [] }

pearls

usecase

Patients with lower back pain in whom spondyloarthritis is in the differential diagnosis.

reasons

next_advice

next_actions

next_management

Strong recommendations for patients with axial SpA from the American College of Rheumatology (ACR) include:

• Use of NSAIDs.
• Use of TNF inhibitors if activity persists despite NSAIDs.
• Avoid using systemic glucocorticoids.
• Physical therapy.
• Hip arthroplasty for patients with advanced hip arthritis.

diseases

[ "Rheumatoid Arthritis" ]

input_schema

[ { "inct": null, "option_fhir_rules": null, "subheading": "Entry criterion:", "subheading_instructions": "", "type": "subheading" }, { "conditionality": null, "default": 0, "label_en": "Back pain ≥3 months and age at onset <45 years", "md_calc_info_concept": null, "name": "backpain", "option_fhir_rules": null, "optional": true, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": false, "tips_en": "", "type": "toggle" }, { "inct": null, "option_fhir_rules": null, "subheading": "Required criteria, ≥1 in addition to the above, both result in positive classification:", "subheading_instructions": null, "type": "subheading" }, { "conditionality": "backpain == 1", "default": 0, "label_en": "<p>Sacroiliitis on imaging</p>", "mdcalc_info_concept": null, "name": "sacro", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": false, "tips_en": "Sacroiliitis on imaging = active (acute) inflammation on MRI highly suggestive of SpA-associated sacroiliitis, or definite radiographic sacroiliitis according to modified New York criteria", "type": "radio" }, { "conditionality": "backpain == 1", "default": 0, "label_en": "<p>HLA-B27</p>", "md_calc_info_concept": null, "name": "hla", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": false, "tips_en": "", "type": "toggle" }, { "inct": null, "option_fhir_rules": null, "subheading": "SpA features, ≥1 required if sacroiliitis on imaging; ≥2 features other than HLA-B27 if HLA-B27 positive:", "subheading_instructions": null, "type": "subheading" }, { "conditionality": "backpain == 1 && (sacro == 0 || hla == 0)", "default": 0, "label_en": "<p>Inflammatory back pain</p>", "md_calc_info_concept": null, "name": "ibp", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": false, "tips_en": "At least 4/5 present: (1) age at onset <40 years, (2) insidious onset, (3) improvement with exercise, (4) no improvement with rest, (5) pain at night with improvement upon getting up", "type": "toggle" }, { "conditionality": "backpain == 1 && (sacro == 0 || hla == 0)", "default": 0, "label_en": "<p>Arthritis</p>", "md_calc_info_concept": null, "name": "arthritis", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": false, "tips_en": "Past or present active synovitis (peripheral) diagnosed by a physician", "type": "toggle" }, { "conditionality": "backpain == 1 && (sacro == 0 || hla == 0)", "default": 0, "label_en": "<p>Enthesitis (heel)</p>", "md_calc_info_concept": null, "name": "enthesitis", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": false, "tips_en": "Past or present spontaneous pain or tenderness at Achilles insertion or plantar fascia at calcaneus", "type": "toggle" }, { "conditionality": "backpain == 1 && (sacro == 0 || hla == 0)", "default": 0, "label_en": "<p>Uveitis</p>", "md_calc_info_concept": null, "name": "uveitis", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": false, "tips_en": "Past or present uveitis anterior, confirmed by an ophthalmologist", "type": "toggle" }, { "conditionality": "backpain == 1 && (sacro == 0 || hla == 0)", "default": 0, "label_en": "<p>Dactylitis</p>", "md_calc_info_concept": null, "name": "dactylitis", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": false, "tips_en": "Past or present, diagnosed by a physician", "type": "toggle" }, { "conditionality": "backpain == 1 && (sacro == 0 || hla == 0)", "default": 0, "label_en": "<p>Psoriasis</p>", "md_calc_info_concept": null, "name": "psoriasis", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": false, "tips_en": "Past or present, diagnosed by a physician", "type": "toggle" }, { "conditionality": "backpain == 1 && (sacro == 0 || hla == 0)", "default": 0, "label_en": "<p>Crohn's disease or ulcerative colitis</p>", "md_calc_info_concept": null, "name": "crohns", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": false, "tips_en": "", "type": "toggle" }, { "conditionality": "backpain == 1 && (sacro == 0 || hla == 0)", "default": 0, "label_en": "<p>Good response to NSAIDs</p>", "md_calc_info_concept": null, "name": "nsaids", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": false, "tips_en": "Resolution or improvement of back pain 24–48 hrs after full dose of NSAID", "type": "toggle" }, { "conditionality": "backpain == 1 && (sacro == 0 || hla == 0)", "default": 0, "label_en": "<p>Family history of SpA</p>", "md_calc_info_concept": null, "name": "famhx", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": false, "tips_en": " Presence in 1st- or 2nd-degree relatives of any of the following: (1) ankylosing spondylitis, (2) psoriasis, (3) acute uveitis, (4) reactive arthritis, (5) IBD", "type": "toggle" }, { "conditionality": "backpain == 1 && (sacro == 0 || hla == 0)", "default": 0, "label_en": "<p>Elevated CRP</p>", "md_calc_info_concept": null, "name": "crp", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": false, "tips_en": "After exclusion of other causes for elevated CRP", "type": "toggle" } ]

instructions

published

2022-04-21T20:29:11.999Z

purpose

[ "Diagnosis" ]

search_terms

[ "Spondyloarthritis", "spa", "spondylitis", "sacroiliitis", "Assessment of Spondyloarthritis International Society", "si joint" ]

seo

{ "keywords_en": "Spondyloarthritis, spa, spondylitis, sacroiliitis, si joint", "meta_description_en": "The ASAS Criteria for Axial Spondyloarthritis (SpA) diagnoses axial spondyloarthritis according to Assessment of Spondyloarthritis International Society (ASAS) criteria." }

specialty

[ "Rheumatology" ]

departments

[ "Musculoskeletal", "Rheumatologic" ]

tags

[]

version_number

1

versions

[]

related

[ { "calcId": "2177", "short_title_en": "CDAI for Rheumatoid Arthritis", "slug": "clinical-disease-activity-index-cdai-rheumatoid-arthritis" }, { "calcId": "2195", "short_title_en": "ACR/EULAR Gout Criteria", "slug": "acr-eular-gout-classification-criteria" }, { "calcId": "2040", "short_title_en": "Steroid Conversion", "slug": "steroid-conversion-calculator" } ]

ismed

false

section

[ "whenToUseViewed", "nextStepsViewed", "evidenceViewed" ]

cleaned_departments

[ "orthopedics", "rheumatology" ]

cleaned_use

[ "Patients with lower back pain in whom spondyloarthritis is in the differential diagnosis." ]

pub

false