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The strength of this study is that the data were collected before the establishment of the ASAS- criteria. The clinical diagnosis in many rheumatic conditions such as SpA is made based on a combination of suggestive symptoms, physical examination findings and complementary testing; therefore, it is guided largely by the “gestalt” rather than quantitative items. These factors could indeed influence the clinical diagnosis and therefore the request of additional testing. On the other hand, this is what is happening in clinical practice to define prognosis and start treatment.
In conclusion, compared with the ESSG and Amor, the ASAS-criteria classify more patients as having axial or peripheral SpA when the rheumatologist’s diagnosis is used as an external standard. Although Colombian physicians in this clinic do not perform HLA-B27 testing or imaging in all patients suspected of having SpA, they do require these tests if the clinical symptoms fall short and suspicion remains.
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