Overview of features included in the different classification criteria sets for AS and SpA

Features of criteria	Modified New York criteria	Amor criteria	ESSG criteria	ASAS axial SpA criteria	ASAS peripheral SpA criteria
Year of publication	1984	1990	1991	2009	2011
Inclusion or entry criteria	Sacroiliitis on radiograph* plus ≥1 clinical criterion	None, fulfillment of criteria requires a score of ≥6 points, assigned on the basis of clinical features that are considered from the list below; weightings for each feature are shown in parentheses	Either IBP or synovitis (asymmetric or predominantly of the lower limbs), plus at least one other SpA feature	≥3 months' back pain before age 45 years and either sacroiliitis on imaging (radiographs or MRI) plus ≥1 other SpA feature (imaging arm) or HLA-B27-positive plus ≥2 other SpA features (clinical arm)	Arthritis, enthesitis or dactylitis plus ≥1 SpA feature marked with^a or ≥2 other SpA features marked with^b
SpA features to be considered
IBP^¶	√	X	X	√	√ (ever)^b
Alternating buttock pain	X	√ or gluteal pain (1 point)	√	X	X
Pain at night or morning stiffness	X	√ (1 point)	X	X	X
Arthritis	X	√ asymmetrical oligoarthritis (2 points)	X	√	√^b
Dactylitis	X	√ (2 points)	X	√	√^b
Enthesitis (heel)	X	√ (2 points)	√	√	√^b
Good response to NSAIDs	X	√ (2 points)	X	√	X
Psoriasis	X	√ (2 points)^Δ	√	√	√^a
Inflammatory bowel disease	X	√ (2 points)^Δ	√	√	√^a
Balanitis	X	√ (2 points)^Δ	X	X	X
Uveitis	X	√ (2 points)	X	√	√^a
Diarrhea <1 month before onset arthritis	X	√ (1 point)	√^◊	X	X
Urethritis/cervicitis <1 month before onset arthritis	X	√ (1 point)	√^◊	X	X
Preceding infection	X	X	X	X	√^a
Positive family history for SpA^§	X	√ (2 points)^¥	√	√	√^b
HLA-B27	X	√ (2 points)^¥	X	√	√^a
Elevated CRP	X	X	X	√	X
Sacroiliitis	Not applicable (see: 'Inclusion or entry criteria' above)	√ (radiographic*; 3 points)	√ (radiographic*)	Not applicable (see: 'Inclusion or entry criteria' above)	√^a (radiographic* or MRI-detected)
Limitation in mobility of lumbar spine	√	X	X	X	X
Limitation in chest expansion	√	X	X	X	X

AS: ankylosing spondylitis; SpA: spondyloarthritis; ESSG: European Spondyloarthropathy Study Group; ASAS: Assessment of SpondyloArthritis International Society; IBP: inflammatory back pain; MRI: magnetic resonance imaging; HLA-B27: human leukocyte antigen-B27; NSAIDs: nonsteroidal antiinflammatory drugs; CRP: C-reactive protein.
* Radiographic sacroiliitis is considered present when at least grade 2 bilaterally or grade 3 to 4 unilaterally.
¶ Different definitions for IBP exist for the different criteria sets.
Δ Presence of psoriasis, balanitis, or inflammatory bowel disease is considered as one item, and 2 points are given in total if at least one is present.
◊ Presence of either urethritis/cervicitis or acute diarrhea within one month before onset of arthritis is sufficient to fulfill this SpA feature in the ESSG criteria.
§ Different definitions for a positive family history exist for the different criteria sets.
¥ Presence of either HLA-B27 positivity or a positive family history is sufficient to obtain the score of 2 points.

Reprinted by permission from Macmillan Publishers Ltd: Nature Reviews Rheumatology. van Tubergen A, Weber U. Diagnosis and classification in spondyloarthritis: identifying a chameleon. Nat Rev Rheumatol 2012; 8:253. Copyright © 2012. www.nature.com/nrrheum.

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Overview of features included in the different classification criteria sets for AS and SpA