Patient selection: acute anterior uveitis
Outcome: referral to a rheumatologist
Parameters:
(1) clinical findings
(2) HLA B-27
Clinical findings – one or more of the following:
(1) inflammatory backache (see below)
(2) sacroiliitis on imaging studies (MRI or X-rays)
(3) joint pain and swelling
(4) heel pain (plantar fasciitis, Achilles tendonitis)
(5) family history of spondyloarthropathy
(6) psoriasis
(7) inflammatory bowel disease (IBD)
In the implementation uveitis was added as one of the clinical findings. It may be necessary to raise the number of clinical findings to 2 from 1.
Criteria for inflammatory backache – 3 or more of the following:
(1) morning stiffness >= 30 minutes
(2) improvement with exercise but not with rest
(3) awakening because of back pain in the second half of the night
(4) alternating buttock pain
The authors also referenced back pain with onset at an age less than 45 years and duration > 3 months.
The patient is referred to a rheumatologist if one or both of the parameters is positive.
