The assessment of the spondyloarthritis international society concept and criteria for the classification of axial spondyloarthritis and peripheral spondyloarthritis: A critical appraisal for the pediatric rheumatologist

Table 5 European Spondylarthropathy Study Group classification criteria and results of their validation in children

Inflammatory back pain or synovitis –symmetric or predominantly in the lower limbs plus
one of the following
·	Positive family history
·	Psoriasis
·	Inflammatory bowel disease
·	Urethritis, cervicitis, or acute diarrhea within one month before arthritis
·	Buttock pain alternating between right and left gluteal areas
·	Enthesopathy
·	Sacroiliitis

Validated in 361 adults with SpA and 455 controls, such criteria showed a sensitivity of 86.7% and specificity of 87.0% ref. [38].
Validated in 2,982 rheumatic children ref. [74], the diagnostic properties of those criteria were 78.7% for sensitivity, 92.2% for specificity, 58.8% and 96.8% for positive and negative predictive values, respectively, 85.3% for positive likelihood ratio, and 90.3 for diagnostic accuracy. Sensitivity of the criterion “inflammatory back pain” was only 9.1% in children.

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