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Medical Author:

Wilfred CG Peh, MD, MBBS, FRCP(Edin), FRCP(Glasg), FRCR, MHSM

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Ankylosing Spondylitis

Criteria for the diagnosis of ankylosing spondylitis were developed at rheumatic disease conferences in Rome and New York and subsequently have been referred to as the Rome criteria (1963) and the New York criteria (1968), respectively. Although these criteria are not perfect, they have been generally accepted to be useful. Sacroiliitis is the distinctive characteristic of ankylosing spondylitis, and its presence is required for the diagnosis under both sets of criteria.

• Rome criteria (1963): Ankylosing spondylitis is present if bilateral sacroiliitis is associated with any of the following criteria:



• Lower back pain and stiffness for more than three months



• Pain and stiffness in the thoracic region



• Limited motion in the lumbar region



• Limited chest expansion



• History of evidence of iritis (inflammation of the iris) or conditions that result from iritis


• New York criteria (1968): Definite ankylosing spondylitis is present if advanced-to-severe bilateral sacroiliitis is associated with at least one of the clinical criteria below or if advanced-to-severe unilateral sacroiliitis or moderate bilateral sacroiliitis is associated with clinical criterion 1 or with both clinical criteria 2 and 3 (see below). Probable ankylosing spondylitis is present if advanced-to-severe bilateral sacroiliitis is associated with none of the criteria. The criteria are as follows:



1. Limited movement ability of the lumbar spine in forward movement, side-to-side movement, and extension

2. History or presence of pain at the thoracolumbar junction or in the lumbar spine

3. Limitation of chest expansion to 1 inch or less