title: Acute anterior uveitis and undiagnosed spondyloarthritis: usefulness of Berlin criteria.
abstract: OBJECTIVE
  Inflammatory back pain, the main symptom in spondyloarthritis, is defined by the presence of two or more positive responses among the four items of Berlin Criteria. This study assesses the value of these criteria in detecting previously undiagnosed spondyloarthritis after an episode of acute anterior uveitis.
  
  
  METHODS
  Records of patients addressed for etiological diagnosis after an acute anterior uveitis (April 2006 to November 2013) were retrospectively analysed. Patient characteristics, the presence of back pain, Berlin Criteria, the final diagnosis, and the ASAS classification criteria for spondyloarthritis were collected and analysed.
  
  
  RESULTS
  The study included 102 patients (59.8% women). The mean age was 44.5 years. Uveitis cases were mainly unilateral (73.5%) and recurrent (58.8%). Twenty-one patients had some type of spondyloarthritis, 20 fulfilling retrospectively the ASAS criteria. Back pain with at least two positive items from Berlin Criteria was 61.9% sensitive and 97.5% specific in diagnosing spondyloarthritis. Considering only one positive item increased the sensitivity (90.5%) but decreased the specificity (91.4%).
  
  
  CONCLUSIONS
  Acute anterior uveitis may be the key symptom that reveals a formerly undiagnosed spondyloarthritis. A referral to a rheumatologist should be considered in presence of back pain, even without fulfilment of the classical definition with Berlin Criteria.
authors.affiliation: Université Claude Bernard Lyon I, Lyon, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Wach
authors.forename: Delphine
authors.initials: D
authors.lastname: Maucort-Boulch
authors.forename: Laurent
authors.initials: L
authors.lastname: Kodjikian
authors.forename: Jean
authors.initials: J
authors.lastname: Iwaz
authors.forename: Christiane
authors.initials: C
authors.lastname: Broussolle
authors.forename: Pascal
authors.initials: P
authors.lastname: Sève
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001416:Back Pain / Q000175:diagnosis*; D001604:Berlin; D003663:Decision Trees; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012955:Societies, Medical / Q000592:standards*; D025241:Spondylarthritis / Q000145:classification / Q000175:diagnosis*; D014606:Uveitis, Anterior / Q000175:diagnosis*