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Spondyloarthropathy
Dec 21, 2024
•
Mark Morgan
categories:
rheumatology
This is a rheumatology decision tool.
Spondyloarthropathy
Note: This decision tool assumes a chronic (6+ weeks), inflammatory
(go to decision tool)
, articular
(go to decision tool)
disorder that affects more than 3 joints asymmetrically
(go back to Chronic Inflammatory Polyarthritis Decision Tool to check)
.
Findings in Spondyloarthropathies
Location/Distribution
1. Asymmetric
2. Predominantly lower extremity
3. Back pain of insidious onset of more than 3 months duration associated with morning stiffness and improvement with activity
Yes
No
<-- QUESTION 1: Is the location/distribution of pain/symptoms in any of the patterns listed above (1-3)?
Comorbid conditions
1. Psoriasis
2. Inflammatory bowel disease
Yes
No
<-- QUESTION 2: Are either of the comorbid conditions above (1-2) present?
Other factors
1. sacroiliitis
2. enthesopathy
3. dactylitis
4. buttock pain (unilateral or alternating)
5. urethritis or cervicitis
6. family history of spondyloarthropathy
7. iritis
8. Acute diarrhea or nongonococcal urethritis within 1 mo of onset
Yes
No
<-- QUESTION 3: Are any of the other factors listed above (1-8) present?
Spondylitis: Inflammatory spinal pain and limitation of movement
Yes
No
<-- QUESTION 4: Is spondylitis present?
Yes
No
<-- QUESTION 5: Is Chlamydia present?
INTERPRETATION -->
Unlikely to be spondyloarthropathy
Enteropathic or psoriatic arthritis may be present
Unlikely to be spondyloarthropathy
Probably Ankylosing Spondylitis
Chlamydia Associated Reactive Arthritis
Probably Reactive Arthritis/Reiter's Syndrome
PLEASE ANSWER QUESTION 1
PLEASE ANSWER QUESTION 2
PLEASE ANSWER QUESTION 3
PLEASE ANSWER QUESTION 4
PLEASE ANSWER QUESTION 5
display/hide references
reference:
Lipsky P. Algorithms for the diagnosis and management of musculoskeletal complaints: A new tool for the primary-care provider. Am J Med. 1997 Dec 29;103(6A):1S-2S.
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