Great review of historical terms that are now outdated and overused. I do feel that CREST syndrome (incomplete or not) still serves a purpose in regards to potential life-threatening pulmonary hypertension as "Limited-Scleroderma" sounds so benign. While one can fulfill criteria for SpA (including B27 negative "sero-negative rheumatoid variants" such as PsA, colitic or enteropathic arthropathy, HS, etc. both with and without axial involvement, the entire concept remains fuzzy and is a label that results in over-diagnosis and over-treatment. The new MACRA formulas for compensation require that our "value" includes patient reports and satisfaction. "Do something, even if its wrong!" Another satisfied customer! Validating uncertainty with diagnostic labels keeps everybody happy and pays the rent!