Development of Criteria to Distinguish Inflammatory from Noninflammatory Arthritis, Enthesitis, Dactylitis, and Spondylitis: A Report from the GRAPPA 2013 Annual Meeting

Objective. To describe a research project to develop simple clinical criteria to aid in the identification of inflammatory arthritis, enthesitis, dactylitis, and spondylitis and distinguish these from noninflammatory conditions. The criteria are particularly intended to aid non-rheumatologists, e.g., dermatologists, who need assistance identifying psoriatic arthritis in patients with psoriasis, but may be useful to all clinicians in properly diagnosing rheumatologic conditions. Methods. The proposed research methodology includes the use of a nominal group exercise among expert clinicians and patient focus groups, Delphi exercises among clinicians and patients, application of criteria test sets to a small group of representative patients with inflammatory and noninflammatory musculoskeletal conditions, and validation by application of optimal criteria sets to large groups of patients with inflammatory and noninflammatory conditions. Results. Examples of elements to describe inflammatory conditions derived from a nominal group exercise conducted at the 2013 GRAPPA annual meeting are described, along with planned project activities. Conclusion. This project will lead to the development of practical criteria to aid in the diagnosis and appropriate clinical care of patients with chronic inflammatory musculoskeletal conditions.