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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.