PMID- 25399389
OWN - NLM
STAT- MEDLINE
DCOM- 20151105
LR  - 20150102
IS  - 1499-2752 (Electronic)
IS  - 0315-162X (Linking)
VI  - 42
IP  - 1
DP  - 2015 Jan
TI  - Classification and diagnosis of axial spondyloarthritis--what is the clinically 
      relevant difference?
PG  - 31-8
LID - 10.3899/jrheum.130959 [doi]
AB  - OBJECTIVE: The Assessment of Spondyloarthritis international Society (ASAS) 
      classification criteria for axial spondyloarthritis (axSpA) have added 
      nonradiographic axSpA (nr-axSpA) to the classic ankylosing spondylitis (AS) as 
      defined by the modified New York criteria. However, some confusion remains about 
      differences between classification and diagnosis of axSpA. Our objective was to 
      analyze differences between classification and diagnostic criteria by discussing 
      each feature of the classification criteria based on real cases. METHODS: The 
      clinical features of the ASAS classification criteria were evaluated in relation 
      to their significance for an expert diagnosis of axSpA. Twenty cases referred to 
      our tertiary center outpatient clinic were selected because of an incorrect 
      diagnosis of axSpA: 10 cases in which axSpA had been excluded initially because 
      the classification criteria were not fulfilled, and 10 patients who had been 
      previously diagnosed with axSpA because the classification criteria were 
      fulfilled. Upon reevaluation, the former were diagnosed with axSpA while the 
      latter had other diseases. RESULTS: All items that are part of the classification 
      criteria show some variability related to their relevance for a diagnosis of 
      axSpA. There are clinical features suggestive of axSpA that are not part of the 
      classification criteria. Misinterpretation of imaging procedures contributed to 
      false-positive results. Rarely, other diseases may mimic axSpA. CONCLUSION: 
      Because the sensitivity and specificity of the axSpA classification criteria have 
      been around 80% in clinical trials, some false-positive and false-negative cases 
      were expected. It is hoped that their detailed description and discussion will 
      help to increase the understanding of diagnosing axSpA in relation to the ASAS 
      classification criteria.
FAU - Braun, Jurgen
AU  - Braun J
AD  - From the Rheumazentrum Ruhrgebiet, Herne; Rheumatologie, Universitatsmedizin 
      Charite, Berlin, Germany.J. Braun, MD, Professor; X. Baraliakos, MD; U. Klitz, 
      MD; F. Heldmann, MD; Rheumazentrum Ruhrgebiet; J. Sieper, MD, Professor, 
      Rheumatologie, Universitatsmedizin Charite. juergen.braun@elisabethgruppe.de.
FAU - Baraliakos, Xenofon
AU  - Baraliakos X
AD  - From the Rheumazentrum Ruhrgebiet, Herne; Rheumatologie, Universitatsmedizin 
      Charite, Berlin, Germany.J. Braun, MD, Professor; X. Baraliakos, MD; U. Klitz, 
      MD; F. Heldmann, MD; Rheumazentrum Ruhrgebiet; J. Sieper, MD, Professor, 
      Rheumatologie, Universitatsmedizin Charite.
FAU - Kiltz, Uta
AU  - Kiltz U
AD  - From the Rheumazentrum Ruhrgebiet, Herne; Rheumatologie, Universitatsmedizin 
      Charite, Berlin, Germany.J. Braun, MD, Professor; X. Baraliakos, MD; U. Klitz, 
      MD; F. Heldmann, MD; Rheumazentrum Ruhrgebiet; J. Sieper, MD, Professor, 
      Rheumatologie, Universitatsmedizin Charite.
FAU - Heldmann, Frank
AU  - Heldmann F
AD  - From the Rheumazentrum Ruhrgebiet, Herne; Rheumatologie, Universitatsmedizin 
      Charite, Berlin, Germany.J. Braun, MD, Professor; X. Baraliakos, MD; U. Klitz, 
      MD; F. Heldmann, MD; Rheumazentrum Ruhrgebiet; J. Sieper, MD, Professor, 
      Rheumatologie, Universitatsmedizin Charite.
FAU - Sieper, Joachim
AU  - Sieper J
AD  - From the Rheumazentrum Ruhrgebiet, Herne; Rheumatologie, Universitatsmedizin 
      Charite, Berlin, Germany.J. Braun, MD, Professor; X. Baraliakos, MD; U. Klitz, 
      MD; F. Heldmann, MD; Rheumazentrum Ruhrgebiet; J. Sieper, MD, Professor, 
      Rheumatologie, Universitatsmedizin Charite.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20141115
PL  - Canada
TA  - J Rheumatol
JT  - The Journal of rheumatology
JID - 7501984
SB  - IM
MH  - Humans
MH  - Sensitivity and Specificity
MH  - Spondylarthritis/*classification/*diagnosis
MH  - Spondylitis, Ankylosing/*classification/*diagnosis
OTO - NOTNLM
OT  - AXIAL SPONDYLOARTHRITIS
OT  - CLASSIFICATION CRITERIA
OT  - DIAGNOSIS
EDAT- 2014/11/17 06:00
MHDA- 2015/11/06 06:00
CRDT- 2014/11/17 06:00
PHST- 2014/11/17 06:00 [entrez]
PHST- 2014/11/17 06:00 [pubmed]
PHST- 2015/11/06 06:00 [medline]
AID - jrheum.130959 [pii]
AID - 10.3899/jrheum.130959 [doi]
PST - ppublish
SO  - J Rheumatol. 2015 Jan;42(1):31-8. doi: 10.3899/jrheum.130959. Epub 2014 Nov 15.