title: The classification and diagnostic criteria of ankylosing spondylitis.
abstract: Ankylosing spondylitis is the prototype of immune-mediated inflammatory rheumatic diseases grouped under the term spondyloarthritis (SpA). An early diagnosis has now become increasingly important because effective therapies are available and anti-TNF drugs are even more effective if used in early stages of the disease. In ankylosing spondylitis, the 1984 modified New York criteria have been used widely in clinical studies and daily practice but are not applicable in early disease when the characteristic radiographic signs of sacroiliitis are not visible but active sacroiliitis is readily detectable by magnetic resonance imaging (MRI). Thus there has been a need for new classification or diagnostic criteria to identify inflammatory spondyloarthritis at early stage of the disease. This led to the concept of axial SpA to include the entire spectrum of patients with axial disease both, with and without radiographic damage. New classification criteria for the wider group of SpA have been proposed by ASAS (Assessment of Spondylo Arthritis International Society); and the patients are sub-grouped into (1) a predominantly axial disease, termed axial SpA including AS and non-radiographic axial SpA; (2) peripheral SpA. The clinical course and disease process of non-radiographic axial spondyloarthritis remains unclear. However the development of the SpA criteria by ASAS particularly for axial SpA, is an important step for early diagnosis and better management of these patients.
authors.affiliation: VA Sacramento Medical Center, Department of Veterans Affairs, Northern California Health Care System, Mather, CA, USA; Department of Medicine, Division of Rheumatology, Allergy and Clinical Immunology, School of Medicine, University of California, Davis, USA. Electronic address: sraychaudhuri@ucdavis.edu.
authors.forename: Siba P
authors.initials: SP
authors.lastname: Raychaudhuri
authors.affiliation: Division of Arthritis & Rheumatic Diseases (OP09), Oregon Health & Science University, Portland, OR 97239, USA.
authors.forename: Atul
authors.initials: A
authors.lastname: Deodhar
mesh_terms: D001416:Back Pain / Q000145:classification / Q000175:diagnosis / Q000209:etiology; D042241:Early Diagnosis; D015796:HLA-B27 Antigen / Q000096:biosynthesis / Q000235:genetics; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D015995:Prevalence; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000145:classification* / Q000175:diagnosis* / Q000188:drug therapy; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D015796:HLA-B27 Antigen; D014409:Tumor Necrosis Factor-alpha
keywords: Ankylosing spondylitis; Diagnosis; Diagnostic criteria; Spondyloarthropathy