According to the ESSG criteria, for a patient to be classified as having SpA, he or she has to satisfy one of two entry criteria: Inflammatory spinal pain OR synovitis that is either asymmetric or predominantly in the lower limbs.
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Inflammatory back pain: Back pain is common among the general population. However, “inflammatory” back pain is much less common. Back pain is considered inflammatory if four of the following five criteria are found:
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Onset of back discomfort before the age of 40 years
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Insidious onset
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Persistence for at least three months
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Associated with morning stiffness
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Improvement with exercise
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Asymmetrical synovitis: Asymmetrical synovitis, predominantly of the lower limbs is manifested by soft tissue swelling, warmth over a joint, joint effusion, and reductions in both active and passive range of motion. As with inflammatory spinal pain, the symptoms are worse after a period of rest.
