ASAS Criteria for Axial Spondyloarthritis (SpA)
ASAS Criteria for Axial Spondyloarthritis (SpA)
Age at Back Pain Onset
Back Pain Duration
Sacroiliitis on Imaging (MRI or X-ray)
HLA-B27 Positive
Inflammatory Back Pain
Arthritis
Enthesitis (Heel)
Uveitis
Dactylitis
Psoriasis
Crohn's Disease / Ulcerative Colitis
Good Response to NSAIDs
Family History of SpA
Elevated CRP
SpA Features:
0
–
–
Classifies axial spondyloarthritis according to Assessment of Spondyloarthritis International Society (ASAS) criteria.
When to Use
Patients with lower back pain in whom spondyloarthritis is in the differential diagnosis.
Formula
Entry criterion: Back pain ≥3 months and age at onset <45 years Required criteria: Sacroiliitis on imaging* plus ≥1 SpA feature, or HLA-B27 plus ≥2 additional SpA features SpA features: Inflammatory back pain Arthritis Enthesitis (heel) Uveitis Dactylitis Psoriasis Crohn’s disease or ulcerative colitis Good response to NSAIDs Family history of SpA HLA-B27 Elevated CRP *Active (acute) inflammation on MRI highly suggestive of SpA-associated sacroiliitis, or definite radiographic sacroiliitis according to modified New York criteria (bilateral grade 2-4 sacroiliitis or unilateral grade 3-4 sacroiliitis, Van Der Linden 1984 ).
Management
Strong recommendations for patients with axial SpA from the American College of Rheumatology (ACR) include: Use of NSAIDs. Use of TNF inhibitors if activity persists despite NSAIDs. Avoid using systemic glucocorticoids. Physical therapy. Hip arthroplasty for patients with advanced hip arthritis.