Reactive arthritis

European Spondyloarthropathy Study Group (ESSG) criteria[67]Dougados M, van der Linden S, Juhlin R, et al. The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum. 1991;34:1218-1227. http://www.ncbi.nlm.nih.gov/pubmed/1930310?tool=bestpractice.com

There are no diagnostic criteria for ReA.

The European Spondyloarthropathy Study Group (ESSG) criteria have been proposed to aid the diagnosis of spondyloarthropathies. Once the diagnosis of spondyloarthropathy is made, further clinical history and symptoms allow identification of the specific spondyloarthropathy, including ReA.

ESSG uses 2 initial screening parameters for further evaluation of a spondyloarthropathy:

1. Inflammatory spinal pain, defined as spinal pain with at least 4 of the following:

   • Onset before age 45 years

   • Insidious onset

   • Improvement with exercise

   • Association with morning stiffness

   • At least 3 months' duration.

2. Synovitis that is asymmetrical or predominantly affects the lower limbs, and 1 or more of the following:

   • Family history, which is described as a first-degree or second-degree relative with any of the following: ankylosing spondylitis, psoriasis, acute uveitis, ReA, or inflammatory bowel disease

   • Psoriasis in the past or present, diagnosed by a physician

   • Inflammatory bowel disease (Crohn's disease or ulcerative colitis) in the past or present, diagnosed by a physician and confirmed by radiographic or endoscopic examination

   • Alternating buttock pain

   • Enthesopathy, defined as past or present spontaneous pain or tenderness on examination of the site of insertion of the Achilles' tendon or plantar fascia

   • Acute diarrhoea occurring within 1 month before arthritis

   • Non-gonococcal urethritis or cervicitis occurring within 1 month before arthritis

   • Radiographic evidence of sacroiliitis.