Amor et al developed a scoring system for the diagnosis of spondylarthropathy based on clinical, radiologic, genetic and therapeutic criteria. The authors are from Paris, France.
Parameters (12 items):
(1) clinical symptoms, current or past history of: 9 items
(2) radiological findings: 1 item
(3) genetic background: 1 item
(4) response to treatment: 1 item
|
Parameter |
Finding |
Points |
|---|---|---|
|
lumbar or dorsal pain at night or morning stiffness of lumbar or dorsal pain |
present |
1 |
|
|
absent |
0 |
|
asymmetrical oligoarthritis |
present |
2 |
|
|
absent |
0 |
|
buttock pain |
none |
0 |
|
|
present |
1 |
|
|
alternating between left and right sides |
2 |
|
sausage-like toe or digit |
present |
2 |
|
|
absent |
0 |
|
heel pain or other well-defined enthesiopathic pain |
present |
2 |
|
|
absent |
0 |
|
iritis |
present |
2 |
|
|
absent |
0 |
|
non-gonococcal urethritis or cervicitis within 1 month before the onset of arthritis |
present |
1 |
|
|
absent |
0 |
|
history of acute diarrhea within 1 month before the onset of arthritis |
present |
1 |
|
|
absent |
0 |
|
psoriasis, balanitis, or inflammatory bowel disease (ulcerative colitis or Crohn's disease) |
present |
2 |
|
|
absent |
0 |
|
sacroiliitis |
bilateral >= 2 |
2 |
|
|
unilateral >= 3 |
2 |
|
|
other |
0 |
|
genetic background |
HLA-B27 |
2 |
|
|
family history of ankylosing spondylitis, reactive arthritis, uveitis, psoriasis or inflammatory bowel disease |
2 |
|
|
neither |
0 |
|
response to NSAID intake |
clear-cut improvement within 48 hours |
2 |
|
|
rapid relapse on discontinuation |
2 |
|
|
neither |
0 |
where:
• Buttock pain in the table from Dougados has "if alternate buttock pain" as 2 points. The ESSG criteria defines pain alternating between the right and left gluteal regions.
• Enthesitis: inflammation of the muscular or tendinous attachment to bone.
score =
= SUM(points for all 12 parameters)
Interpretation:
• minimum score: 0
• maximum score: 21
• A score >= 6 indicates that the patient has a spondylarthropathy.
Purpose: To evaluate a patient for spondylarthropathy using the criteria of Amor et al.
Specialty: Immunology/Rheumatology
Objective: criteria for diagnosis
ICD-10: M45,
