Observations on diagnostic criteria for ankylosing spondylitis.

The Rome and New York criteria for ankylosing spondylitis (AS) have been compared in a clinical sample of patients with this disease and other joint disorders. The best individual clinical discriminator was the first Rome criterion, low back pain and stiffness lasting for three months and, in contrast, the New York criterion of dorsolumbar pain performed poorly. On the other hand, the more stringent New York formulation of lumbar spine limitation in all three planes came out as a better discriminator than its Rome counterpart. Both sets of radiographic criteria performed well. Ethical problems remain, which suggests that new criteria need to be developed for use in population surveys. Peripheral joint involvement was also assessed, but there did not appear to be any merit in taking this into account in any subsequent revision of diagnostic criteria for AS.