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New Classification Criteria for Spondyloarthritis

Martin Rudwaleit, MD

Spondyloarthritides (SpA) encompass a group of interrelated inflammatory rheumatic conditions with a shared genetic background and overlapping clinical manifestations. Anklyosing spondylitis (AS) – as the prototype subgroup of SpA – is characterized by inflammatory back pain, impaired spinal mobility, and definite sacroiliitis on radiographs. However, many patients who evolve to AS have typical axial symptoms (i.e. inflammatory back pain) years before definite sacroiliitis on radiographs appears. Magnetic resonance imaging (MRI) can visualize sacroiliitis in patients with hitherto normal radiographs of the sacroiliac joints. To better characterize all SpA patients with predominant involvement of the axial skeleton, the term “axial SpA” has been coined as an umbrella for the entire disease continuum, from mild non-radiographic axial SpA to established AS. The Assessment of SpondyloArthritis international Society (ASAS) has recently generated and validated new classification criteria for axial SpA. These new ASAS criteria for axial SpA are applicable to patients with AS but also to patients with active sacroiliitis on MRI without definite structural damage, thus facilitating studies and clinical trials in early axial SpA and helping to establish a diagnosis.Int J Adv Rheumatol 2010;8(1):1–7.

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