THURSDAY, Feb. 23 (HealthDay News) -- A new set of criteria to diagnose inflammatory back pain associated with ankylosing spondylitis may help differentiate the condition from mechanical low back pain, according to a study published in the February issue of Arthritis & Rheumatism.
Martin Rudwaleit, M.D., of the German Rheumatology Research Centre in Berlin, and colleagues analyzed the clinical history of 213 patients with chronic back pain, including 101 with ankylosing spondylitis and the rest with mechanical low back pain.
The investigators identified six independent factors associated with inflammatory back pain: morning stiffness lasting longer than 30 minutes, age at onset, no improvement after rest, awakening as a result of back pain in the second half of the night, alternating pain in the buttocks, and time period at onset of back pain.
Individually, the parameters did not differentiate ankylosing spondylitis from mechanical low back pain. However, in combination, four of them -- morning stiffness for longer than 30 minutes, improvement in back pain with exercise but not with rest, awakening due to back pain in the second half of the night, and alternating buttock pain -- had 70.3 percent sensitivity and 81.2 percent specificity for the condition.
"For diagnostic purposes, a multilevel approach to the application of inflammatory back pain criteria is conceivable. We have proposed a new set of inflammatory back pain criteria that appears to be superior to existing sets, but this needs to be validated in a prospective study," the authors conclude.
Abstract
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