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ASAS Criteria for Peripheral SpondyloArthritis (SpA)

Classifies peripheral spondyloarthritis in patients with arthritis, enthesitis, or dactylitis.

ASAS Criteria for Peripheral SpondyloArthritis (SpA)
Arthritis
Entry criterion; also counted in List B.
Enthesitis
Entry criterion; also counted in List B.
Dactylitis
Entry criterion; also counted in List B.
Psoriasis
List A feature.
Crohn's disease / ulcerative colitis
List A feature.
Preceding infection
List A feature.
HLA-B27 positive
List A feature.
Uveitis (anterior, past or present)
List A feature.
Sacroiliitis on imaging
List A feature.
Inflammatory back pain, ever (past or present)
List B feature.
Family history of spondyloarthritis
List B feature.
ResultDoes not meet criteria

Entry criterion (arthritis, enthesitis, or dactylitis) not met; criteria are not applicable.

Entry criterion met (arthritis/enthesitis/dactylitis)
No
List A features (need >=1)
0
List B features (need >=2)
0

When to use

  • Classifying peripheral spondyloarthritis in patients presenting with arthritis, enthesitis, or dactylitis and no (or minor) axial symptoms.
  • Complements the axial SpA criteria to cover the full spondyloarthritis spectrum, for research and cohort classification.

Formula

Entry: arthritis or enthesitis or dactylitis. Plus EITHER >=1 List A feature (psoriasis, IBD, preceding infection, HLA-B27, uveitis, sacroiliitis on imaging) OR >=2 List B features (arthritis, enthesitis, dactylitis, inflammatory back pain ever, family history of SpA).

Pearls and pitfalls

  • Sensitivity ~78% and specificity ~82% in the ASAS validation cohort.
  • Arthritis, enthesitis, and dactylitis each count both toward the entry criterion and toward List B.

References

  1. Rudwaleit M, van der Heijde D, Landewé R, et al. The Assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis. 2011;70(1):25-31.