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Performance of various criteria sets in patients with inflammatory back pain of short duration; the Maastricht early spondyloarthritis clinic
  1. L Heuft-Dorenbosch1,
  2. R Landewé1,
  3. R Weijers4,
  4. H Houben3,
  5. S van der Linden3,
  6. P Jacobs2,
  7. D van der Heijde1
  1. 1Department of Internal Medicine, Division of Rheumatology, University Hospital Maastricht, Maastricht, The Netherlands
  2. 2Laurentius Hospital, Roermond, The Netherlands
  3. 3Department of Rheumatology, Atrium Medical Center, Heerlen, The Netherlands
  4. 4Department of Radiology, University Hospital Maastricht, Maastricht, The Netherlands
  1. Correspondence to:
    Professor D van der Heijde
    Department of Internal Medicine, Division of Rheumatology, University Hospital Maastricht, PO Box 5800, 6202AZ Maastricht, The Netherlands; dhe{at}


Aim: To describe how patients presenting with inflammatory back pain (IBP) of short duration can be classified by different sets of classification criteria for spondyloarthritis (SpA) and ankylosing spondylitis, and which clinical and imaging features are of discernible importance.

Methods: 68 patients with IBP of a maximum of 2 years’ duration were included in the early spondyloarthritis cohort. Detailed history, clinical examination and imaging of sacroiliac joints by plain radiography and magnetic resonance imaging (MRI) were obtained. The Berlin criteria set for SpA that has a prominent place for MRI and human leucocyte antigen B27 was used to quantify the relative contribution of MRI in classifying SpA.

Results: 14 of the 68 patients had ankylosing spondylitis according to the modified New York criteria, 57 patients fulfilled the European Spondylarthropathy Study Group (ESSG) criteria for SpA, 48 patients fulfilled the Amor criteria for SpA (43 patients fulfilled both criteria sets) and 44 patients fulfilled the Berlin criteria for SpA. Only four patients did not fulfil any criteria set; 36 patients fulfilled ESSG, Amor and Berlin criteria. The 14 patients with ankylosing spondylitis fulfilled all three SpA criteria sets.

Conclusion: Among our selected cohort of patients with early IBP, the prevalence of SpA according to three different criteria sets is high. The ESSG criteria were the most sensitive, followed by the Amor criteria and the Berlin criteria. The modified New York criteria for ankylosing spondylitis appeared to be the most specific. In this cohort, the contribution of MRI and human leucocyte antigen B27 to purely clinical criteria in making a diagnosis of axial SpA was limited.

  • ESSG, European Spondylarthropathy Study Group
  • HLA-B27, human leucocyte antigen B27
  • IBD, inflammatory bowel disease
  • IBP, inflammatory back pain
  • MRI, magnetic resonance imaging
  • NSAID, non-steroidal anti-inflammatory drugs
  • SpA, spondyloarthritis

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  • Published Online First 25 July 2006

  • Funding: This study was partly supported by a grant from the Dutch Arthritis Association.