SpA was defined by the criteria of the European Spondylarthropathy Study Group in 1991. The full article was not able to be accessed, but the material I have found is from the abstract of the original article. "Based on statistical analysis and clinical reasoning, we propose the following classification criteria for spondylarthropathy: inflammatory spinal pain or synovitis (asymmetric or predominantly in the lower limbs), together with at least 1 of the following: positive family history, psoriasis, inflammatory bowel disease, urethritis, or acute diarrhea, alternating buttock pain, enthesopathy, or sacroiliitis as determined from radiography of the pelvic region."
RA was defined by the criteria according to the American College of Rheumatology, formerly known as the American Rheumatism Association. This criteria was also published years prior to the publishing of the article discussed in class. The definition of RA, according to "The American Rheumatism Association 1987 Revised Criteria For The Classification of Rheumatoid Arthritis," is as follows: "1) morning stiffness in and around joints lasting at least 1 hour before maximal improvement; 2) soft tissue swelling (arthritis) of 3 or more joint areas observed by a physician; 3)swelling (arthritis) of the proximal interphalangeal, metacarpophalangeal, or wrist joints; 4) symmetric swelling (arthritis); 5) rheumatoid nodules; 6) the presence of rheumatoid facto; and 7) radiographic erosions and/or periarticular osteopenia in hands and/or wrist joints. Criteria 1 through 4 must be present for 6 weeks. Rheumatoid arthritis is defined by the presence of 4 or more criteria, and no further qualifications (classic, definite, or probable) or lists of exclusions are required."
OA was also defined by ACR criteria, though from 1986. The data was put into a table and put into three categories: Clinical and Laboratory, Clinical and Radiographic, and Clinical t.
Under Clinical and Laboratory criteria, knee pain and at least 5 of 9 criteria must be met: age > 50, stiffness < 30 minutes, crepitus, bony tenderness, bony enlargement, no palpable warmth, erythrocyte sedimentation rate (ESR) < 40 mm/hour, rheumatoid factor (RF) < 1:40, and synovial fluid signs of osteoarthritis (SF OA).
Under Clinical and Radiographic criteria, knee pain and at least 1 of 3 criteria must be met: age > 50, stiffness < 30 minutes, and crepitus + osteophytes.
Under Clinical t criteria, knee pain and at least 3 of 6 criteria must be met: age > 50, stiffness < 30 minutes, crepitus, bony tenderness, bony enlargement, and no palpable warmth.
I find it strange that a scientific article submitted in 2007 is using criterion published in 1986, 1988, and 1991, while there is much more recently published criteria for OA, RA, and SpA available. Anyone have any thoughts?
Resources:
1. Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification
of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association.
Arthritis Rheum 1986;29(8):1039-49.
2. Arnett FC, Edworthy SM, Bloch DA, et. al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988 Mar;31(3):315-24.
3. Dougados M, van der Linden S, Juhlin R, Huitfeldt B, Amor B, Calin A, Cats A, Dijkmans B, Olivieri I, Pasero G. The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum. 1991;34:1218-1227.
