Purpose: In order to identify patients likely to present with spinal pain due to Ankylosing Spondylitis.

Stage of CPR Development: Validated.

Tests:

1. Morning stiffness > 30 min
2. Improvement in back pain with exercise but not with rest
3. Awakening because of back pain during the second half of the night only
4. Alternating buttock pain

Interpretation:

Study Sensitivity Specificity +LR -LR
Rudwaleit et al., 2006 0.70 0.81 3.70 0.40
Sieper et al., 2009 0.84 0.63 2.20 0.26
Sieper et al., 2009 0.70 0.81 3.80 0.37
Chan et al., 2012 0.92 0.67 2.80 0.12

Research:

1. Chan CC, Inrig T, Molloy CB, Stone MA, Derzko-Dzulynsky L. Prevalence of inflammatory back pain in a cohort of patients with anterior uveitis. Am J Ophthalmol. 2012;153:1025-1030.e1. http://dx.doi.org/10.1016/j.ajo.2011.11.016

2. Rudwaleit M, Metter A, Listing J, Sieper J, Braun J. Inflammatory back pain in ankylosing spondylitis: a reassessment of the clinical history for application as classification and diagnostic criteria. Arthritis Rheum. 2006;54:569-578. http:// dx.doi.org/10.1002/art.21619

3. Sieper J, van der Heijde D, Landewé R, et al. New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ASAS). Ann Rheum Dis. 2009;68:784-788. http:// dx.doi.org/10.1136/ard.2008.101501