ORIGINAL ARTICLECan some cases of ‘possible’ spondyloarthropathy be classified as ‘definite’ or ‘undifferentiated’ spondyloarthropathy?Value of criteria for spondyloarthropathies
Section snippets
Initial study population
A multicenter study [15] was conducted by 28 rheumatology centers in 20 Spanish cities to validate Amor’s criteria and the ESSG criteria. The methodology was similar to that used earlier in a French validation study [13]. All the outpatients and inpatients seen during a one-week period were included. Rheumatologists used their personal experience (without reference to the criteria under study) to classify the patients into three groups, namely, definite spondyloarthropathy, possible
Characteristics at baseline
Table I reports the characteristics in the 102 patients with possible spondyloarthropathy. The most common symptoms were pain, morning stiffness of the lumbar spine, inflammatory back pain, and ill-defined buttock pain. A favorable response to nonsteroidal anti-inflammatory drug therapy was common.
Of the 102 patients, 49 did and 53 did not meet Amor’s criteria; corresponding figures for the ESSG criteria were 70 and 32. Table II shows the characteristics in these subgroups. No differences were
Discussion
In our outcome study, 13 of 52 patients had a spondyloarthropathy at completion of the five-year period. Seven patients were lost to follow-up, and 25 did not have a spondyloarthropathy. Amor’s criteria at baseline had a positive predictive value of 76% and a negative predictive value of 89% for spondyloarthropathy. Thus, use of these criteria at baseline would have ensured correct classification of most of the patients. The performance characteristics of the ESSG criteria in the same patients
Acknowledgements
We are grateful to the organizations that provided financial support to this study: the Fundación Hospital Reina Sofía-Cajasur, Junta de Andalucía (Consejería de Salud), and the Association cordouane contre la spondylarthrite ankylosante (ACEADE-LIRE). We thank Ms. Edith Wetcheler, and Mr. Nicolas Van Grunderbeeck (medical student, Erasmus program) for his technical assistance.
Members of the Spanish Spondyloarthropathy Study Group
M. Acasuso (La Coruña); E. Calero (Málaga); A. Collado
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