A clinical classification for anal involvement by Crohn's disease was developed at the University of Wales. This is useful in describing the extent of a patient's disease involvement and can be used to monitor responses to therapy. The author is from the University of Wales in Cardiff.
General format: abbreviation for parameter + severity:
(1) abbreviation for primary classification: U, F, S
(2) abbreviation for subsidiary classification: A, P, D
(3) severity: 0 (absent), 1 (mild or moderate clinical impact), 2 (severe clinical impact)
Cardiff UFS Classification, Clinical Version
|
Parameter |
Finding |
Designation |
|---|---|---|
|
ulceration (U) |
not present |
U0 |
|
|
superficial fissure |
U1 |
|
|
cavitating ulcer |
U2 |
|
fistula and/or abscess (F) |
not present |
F0 |
|
|
low and/or superficial |
F1 |
|
|
high and/or complex |
F2 |
|
stricture (S) |
not present |
S0 |
|
|
spasm and/or membranous |
S1 |
|
|
severe fibrotic |
S2 |
from Table 4, page 932
Cardiff UFS Classification, Research Version
|
Parameter |
Finding |
Designation |
|---|---|---|
|
ulceration (U) |
not present |
U0 |
|
|
superficial fissure, posterior and/or anterior |
U1a |
|
|
superficial fissure, lateral |
U1b |
|
|
superficial fissure, with gross skin tags |
U1c |
|
|
cavitating ulcers, anal canal |
U2a |
|
|
cavitating ulcers, lower rectum |
U2b |
|
|
cavitating ulcers, with extension to perineal skin (aggressive ulceration) |
U2c |
|
fistula and/or abscess (F) |
not present |
F0 |
|
|
low and/or superficial, |
F1a |
|
|
low and/or superficial, |
F1b |
|
|
low and/or superficial, |
F1c |
|
|
low and/or superficial, |
F1d |
|
|
high, blind supralevator |
F2a |
|
|
high direct (anorectal) |
F2b |
|
|
high complex |
F2c |
|
|
high, rectovaginal |
F2d |
|
|
high, ileoperineal |
F2e |
|
stricture (S) |
not present |
S0 |
|
|
reversible stricture, anal canal with spasm |
S1a |
|
|
reversible stricture, low rectum -membranous |
S1b |
|
|
reversible stricture, spasm with severe pain (no sepsis identified) |
S1c |
|
|
irreversible stricture, anal stenosis |
S2a |
|
|
irreversible stricture, extrarectal |
S2b |
from Table 2, page 931
Example: U1a,c,U2b,F2a,S0 = presence of posterior anal fissure with gross skin tags; rectal cavitating ulcer; high perianal fistula with blind supralevator element; no anal or rectal stricture (from page 931)
Subsidiary APD classification
|
Parameter |
Finding |
Designation |
|---|---|---|
|
associated anal conditions (A) |
none |
A0 |
|
|
hemorrhoids |
A1 |
|
|
malignancy |
A2 |
|
|
other (specify) |
A3 |
|
proximal intestinal disease (P) |
no proximal disease |
P0 |
|
|
contiguous rectal disease |
P1 |
|
|
colon (rectum spared) |
P2 |
|
|
small intestine |
P3 |
|
|
investigation incomplete |
P4 |
|
disease activity in anal lesions (D) |
active |
D1 |
|
|
inactive |
D2 |
|
|
inconclusive |
D3 |
from Table 3, page 931
Specialty: Gastroenterology
